Individual
KRISTEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
39325 PLYMOUTH RD STE 202, LIVONIA, MI 48150-4531
(734) 787-3802
Mailing address
518 THOMAS ST, YPSILANTI, MI 48198-3016
(734) 787-3802
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401222505
MI
Other
Enumeration date
08/27/2020
Last updated
03/13/2024
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