Individual
PAULA MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3722 S STRAITS HWY, INDIAN RIVER, MI 49749-5117
(231) 622-3323
(231) 681-1004
Mailing address
8378 DEKRUIF RD, LEVERING, MI 49755-9740
(231) 622-3323
(231) 681-1004
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401010902
MI
Other
Enumeration date
02/25/2011
Last updated
08/15/2022
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