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Individual

MRS. AMANDA WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
517 DELTONA BLVD, DELTONA, FL 32725-8016
(407) 202-1095
Mailing address
1813 RIDGE VALLEY ST, CLERMONT, FL 34711-6490
(407) 340-2449

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
01/03/2014
Last updated
01/03/2014
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