| Doctor Name: | MRS. AMANDA OGLESBY WILSON |
| NPI Number: | 1871723239 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED., LPC, NCC |
| License Number: | 1067 |
| Business Practice Address: | 561 N Robinson St Senatobia, MS - 386682118 |
| Business Phone Number: | 6622094290 |
| Business Fax Number: | |
| Mailing Address: | 26104 Highway 4 E, SENATOBIA |
| State: | MS |
| Postal Code: | 386685901 |
| Phone Number: | 6622094290 |
| Fax Number: | |
| NPI Enumeration Date: | 07/20/2009 |
| NPI Last Update Date: | 09/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1067 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |