Individual
ASHLEY BLAIR WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6001 CIMMARON TRL, LAGO VISTA, TX 78645-5205
(832) 482-7802
Mailing address
PO BOX 4230, LAGO VISTA, TX 78645-0005
(832) 482-7802
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
10/02/2024
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