Doctor Name: | JOEY M WILSON |
NPI Number: | 1013034297 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LPC |
License Number: | 4604 |
Business Practice Address: | 9189 S Turkey Creek Rd Morrison, CO - 804659422 |
Business Phone Number: | 3036975049 |
Business Fax Number: | 3036975083 |
Mailing Address: | 9189 South Turkey Creek Road, MORRISON |
State: | CO |
Postal Code: | 80465 |
Phone Number: | 3036975049 |
Fax Number: | 3036975083 |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4604 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |