Individual
CELIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, OC PSII, CDCA
Contact information
Practice address
3905 E 153RD STREET, CLEVELAND, OH 44128-1174
(440) 317-2496
Mailing address
PO BOX 202644, CLEVELAND, OH 44120-8127
(440) 317-2496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
080581
OH
174H00000X
Health Educator
Primary
1094-C08
OH
Other
Enumeration date
07/13/2010
Last updated
01/10/2011
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