Individual
KELLI LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1247 AIRPORT ROAD, CLARENDON, VT 05759
(802) 773-3620
Mailing address
1247 AIRPORT RD, NORTH CLARENDON, VT 05759-9398
(802) 773-3620
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
1000000042
VT
106H00000X
Marriage & Family Therapist
Primary
LF61165203
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00068963
BCBS
VT
05
—
1010469
—
VT
Enumeration date
10/17/2006
Last updated
11/17/2025
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