Individual
MRS. STEPHANIE LOUISE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
6010 W BROAD ST STE 103, RICHMOND, VA 23230-2215
(804) 282-1863
Mailing address
6010 W BROAD ST STE 103, RICHMOND, VA 23230-2215
(804) 282-1863
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001541
VA
Other
Enumeration date
03/14/2021
Last updated
08/10/2021
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