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General NPI Number Information
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NPI Number | 1093235566
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Entity Type | Individual
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Provider Name | ALIYAH WILSON M.ED., LPCC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 7031 CORPORATE WAY STE 103
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City | DAYTON
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State | OH
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Zip | 45459-4262
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Country | US
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Telephone | 937-619-9089
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Fax |
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Provider Business Mailing Address
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Address Line | 24781 PICONE LN
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City | BEDFORD HEIGHTS
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State | OH
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Zip | 44146-1948
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Country | US
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Telephone | 216-513-7044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.1700415
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2102295
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License Number State | OH
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