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Individual

MARIE ELIZABETH WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
4339 WINSTON AVE, COVINGTON, KY 41015-1739
(859) 835-2573
(859) 727-6327
Mailing address
4339 WINSTON AVE, COVINGTON, KY 41015-1739
(859) 835-2573
(859) 727-6327

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
103365
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100291250
KY
Enumeration date
07/01/2010
Last updated
05/31/2016
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