Individual
LAURREL SUSAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
5900 W 17TH AVE, KENNEWICK, WA 99338-1409
(509) 572-0633
Mailing address
5900 W 17TH AVE, KENNEWICK, WA 99338-1409
(509) 572-0633
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
60604431
WA
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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