Individual
CRYSTAL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
970 EXECUTIVE PARKWAY DR, SAINT LOUIS, MO 63141-6302
(314) 628-6500
(314) 514-9916
Mailing address
970 EXECUTIVE PARKWAY DR, SAINT LOUIS, MO 63141-6302
(314) 628-6500
(314) 514-9916
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2015026784
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/12/2015
Last updated
11/20/2024
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