Individual
MRS. JULIE ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
86B MARTIN LN, MORIARTY, NM 87035-5605
(505) 659-8721
Mailing address
86B MARTIN LN, MORIARTY, NM 87035-5605
(505) 659-8721
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99999
LMHC
NM
Enumeration date
01/25/2023
Last updated
01/25/2023
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