Individual
JESSICA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, ALC
Contact information
Practice address
3802 OFC. TREVOR S. PHILLIPS AVE, SUITE A, TUSCALOOSA, AL 35401
(205) 722-7294
Mailing address
1105 SOUTHVIEW LN STE 103-254, TUSCALOOSA, AL 35405-6390
(205) 722-7294
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ALC03973
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
12/19/2022
Last updated
12/19/2022
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