Individual
CORYNNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
227 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-9548
(609) 748-8992
Mailing address
227 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-9548
(609) 748-8992
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37PC00532900
NJ
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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