Individual
ASHLEY MB WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA/LPA
Contact information
Practice address
413 BROADWAY ST STE A, PADUCAH, KY 42001-0738
(270) 217-5218
Mailing address
413 BROADWAY ST STE A, PADUCAH, KY 42001-0738
(630) 615-0605
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
273301
KY
103TC0700X
Clinical Psychologist
Primary
273301
KY
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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