Doctor Name: | BETH L WILSON |
NPI Number: | 1871918466 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ALC |
License Number: | C1809A |
Business Practice Address: | 3 Office Park Cir Suite 105 Mountain Brk, AL - 352232510 |
Business Phone Number: | 2057450533 |
Business Fax Number: | 2058020773 |
Mailing Address: | 3 Office Park Cir, Suite 105 MOUNTAIN BRK |
State: | AL |
Postal Code: | 352232510 |
Phone Number: | 2057450533 |
Fax Number: | 2058020773 |
NPI Enumeration Date: | 02/19/2014 |
NPI Last Update Date: | 02/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | C1809A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |