Individual
AMY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3292 COUNTY ROAD 220, MIDDLEBURG, FL 32068-4357
(904) 291-5561
(904) 291-5575
Mailing address
1726 KINGSLEY AVE STE 2, ORANGE PARK, FL 32073-4411
(904) 291-5561
(904) 291-5575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH18475
FL
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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