Individual
DARLENE LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1597 N. HIGHWAY 63, HOUSTON, MO 46548
(417) 967-2887
Mailing address
1597 NORTH HIGHWAY 63, HOUSTON, MO 65483
(417) 967-2887
(417) 967-2201
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2011024575
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972853380
—
MO
Enumeration date
09/12/2012
Last updated
09/19/2017
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