Individual
KASEY L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADC-T
Contact information
Practice address
413 COMMERCIAL AVE N, SANDSTONE, MN 55072-4412
(320) 245-9966
Mailing address
PO BOX 286, SANDSTONE, MN 55072-0286
(320) 245-9966
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MNCD302809
MN
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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