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NPI Code Detail

MEDICARE: CHRISTINE WILSON MS, ATR, LPC

MEDICARE: CHRISTINE WILSON MS, ATR, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorP1210100AR

General Provider Information

NPI Number : 1699057851
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE WILSON MS, ATR, LPC
Provider Business Mailing Address
First Line : 10800 FINANCIAL CENTRE PKWY STE 290
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-3581
Country : US
Telephone Number : 501-781-2230
Fax Number : 888-816-7916
Provider Business Practice Location Address
First Line : 10800 FINANCIAL CENTRE PKWY STE 290
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-3581
Country : US
Telephone Number : 501-781-2230
Fax Number : 888-816-7916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 04/15/2014

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