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General NPI Number Information
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NPI Number | 1821151226
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Entity Type | Individual
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Provider Name | ALICE FAITH WILSON MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 14515 BRIARHILLS PKWY SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77077-1034
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Country | US
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Telephone | 281-741-2828
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Fax | 713-741-2828
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Provider Business Mailing Address
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Address Line | 14515 BRIARHILLS PKWY SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77077-1034
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Country | US
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Telephone | 281-741-2828
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Fax | 713-481-1643
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12238 LPC
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12238
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License Number State | TX
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