Individual
DWIGHT WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
512 BOWLING GREEN RD, SCOTTSVILLE, KY 42164-8303
(270) 237-4481
(270) 237-4858
Mailing address
512 BOWLING GREEN RD, SCOTTSVILLE, KY 42164-8303
(270) 237-4481
(270) 237-4858
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0343
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
11/12/2008
Last updated
11/12/2008
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