Individual
ANGELA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2111 E BASELINE RD STE C3, TEMPE, AZ 85283-1521
(602) 540-3593
Mailing address
1616 N CENTRAL AVE APT 1407, PHOENIX, AZ 85004-1660
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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