Healthcare Provider Details

I. General information

NPI: 1114884822
Provider Name (Legal Business Name): WILSON WELLNESS & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 LONEROCK DR
ANNA TX
75409-6068
US

IV. Provider business mailing address

801 LONEROCK DR
ANNA TX
75409-6068
US

V. Phone/Fax

Practice location:
  • Phone: 214-810-3936
  • Fax:
Mailing address:
  • Phone: 504-708-9212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JASMIN JENAY WILSON
Title or Position: SOCIAL WORKER
Credential: LCSW
Phone: 504-708-9212