| Doctor Name: | CHRISTINE ALLENE WILSON |
| NPI Number: | 1073688677 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M. ED.PSYCH. |
| License Number: | LH00004755 |
| Business Practice Address: | 417 N Maple St Colville, WA - 991143013 |
| Business Phone Number: | 5096900715 |
| Business Fax Number: | |
| Mailing Address: | 417 N Maple St, COLVILLE |
| State: | WA |
| Postal Code: | 991143013 |
| Phone Number: | 5096900715 |
| Fax Number: | |
| NPI Enumeration Date: | 11/21/2006 |
| NPI Last Update Date: | 08/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH00004755 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |