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General NPI Number Information
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NPI Number | 1396918181
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Entity Type | Organization
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Legal Business Name | WILSON COUNSELING AND WELLNESS, PLLC
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 387 S SWING RD
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City | GREENSBORO
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State | NC
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Zip | 27409-2009
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Country | US
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Telephone | 336-327-4453
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Fax |
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Provider Business Mailing Address
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Address Line | 387 S SWING RD
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City | GREENSBORO
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State | NC
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Zip | 27409-2009
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Country | US
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Telephone | 336-327-4453
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. TASHA DANIELLE WILSON
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Credential | LPC
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Telephone | 336-327-4453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6849
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License Number State | NC
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