Individual
MARTA A. T. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT, CPC, LCADC
Contact information
Practice address
6375 W CHARLESTON BLVD, STE. A-172, LAS VEGAS, NV 89146-1139
(702) 877-0684
(702) 877-0684
Mailing address
6375 W CHARLESTON BLVD, STE. A-100, LAS VEGAS, NV 89146-1139
(702) 253-0818
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
01035
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100508688
—
NV
Enumeration date
06/09/2006
Last updated
12/30/2009
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