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General NPI Number Information
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NPI Number | 1598585077
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Entity Type | Individual
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Provider Name | JASALEE WILSON LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 5189 TEXAS AVE
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City | ABILENE
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State | TX
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Zip | 79605-4529
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Country | US
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Telephone | 325-232-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 36 SW AVENUE E
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City | HAMLIN
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State | TX
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Zip | 79520-3814
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Country | US
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Telephone | 325-439-9556
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 95840
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License Number State | TX
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