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General NPI Number Information
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NPI Number | 1508778143
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Entity Type | Individual
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Provider Name | KATHI WILSON BS, MA
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Gender | Female
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 701 SANTA ISABEL BLVD # 3
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City | LAGUNA VISTA
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State | TX
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Zip | 78578-2647
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Country | US
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Telephone | 832-315-1981
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Fax |
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Provider Business Mailing Address
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Address Line | 701 SANTA ISABEL BLVD # 3
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City | LAGUNA VISTA
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State | TX
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Zip | 78578-2647
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Country | US
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Telephone | 832-315-1981
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 71456
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 71456
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License Number State | TX
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