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General NPI Number Information
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NPI Number | 1730746389
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Entity Type | Individual
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Provider Name | ASHLEY RAE WILSON LPC
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 7300 DIXIE HWY STE 1000
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City | CLARKSTON
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State | MI
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Zip | 48346-5105
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Country | US
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Telephone | 517-492-0784
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 517-492-0784
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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 | 1801410
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401222388
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401018161
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License Number State | MI
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