Individual
JANA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S. MHP
Contact information
Practice address
560 OAKLAND CIR, PADUCAH, KY 42003-8924
(127) 081-6267
Mailing address
PO BOX 701, PADUCAH, KY 42002-0701
(270) 816-2671
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
168587
KY
101YM0800X
Mental Health Counselor
Primary
272387
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168587
LICENSED PROFESSIONAL COUNSELOR ASSOCIATE
KY
Enumeration date
01/31/2014
Last updated
09/03/2021
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