| Doctor Name: | DEBBIE A WILSON |
| NPI Number: | 1144499575 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CAC-1 |
| License Number: | 1-04055 |
| Business Practice Address: | 651 N State St Caro, MI - 487231543 |
| Business Phone Number: | 9896735700 |
| Business Fax Number: | 9896722555 |
| Mailing Address: | 467 N State St, CARO |
| State: | MI |
| Postal Code: | 487231539 |
| Phone Number: | 9896726160 |
| Fax Number: | 9896726272 |
| NPI Enumeration Date: | 02/29/2008 |
| NPI Last Update Date: | 02/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1-04055 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |