Individual
ANDREE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
701 S 9TH ST, CANON CITY, CO 81212-4911
(719) 275-2351
Mailing address
701 S 9TH ST, CANON CITY, CO 81212-4911
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
21721
CO
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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