Individual
PHERIBA THERESA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3404 N LECANTO HWY, BEVERLY HILLS, FL 34465-3569
(352) 419-4856
Mailing address
6005 E WILLOW ST, INVERNESS, FL 34452-8166
(352) 560-1226
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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