Individual
MS. KIMBERLY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3238 LONG IRON PL, LAWRENCEVILLE, GA 30044-2513
(678) 653-3324
Mailing address
3238 LONG IRON PL, LAWRENCEVILLE, GA 30044-2513
(678) 653-3324
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC014060
GA
101YP2500X
Professional Counselor
LPC014060
GA
Other
Enumeration date
08/14/2023
Last updated
06/05/2025
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