Provider Information for 1447274469
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Ms. BENITA WILSON MA,NCC,LMHC,LPC
Sex: Female
NPI: 1447274469
Last Updated: 2012-10-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1447274469 | ||||||||||||
| Enumeration Date | 2006-07-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 8528 GOLF RIDGE DR CHARLOTTE, NC 28277-8836 United States Phone: 917-686-6406 | Fax: | ||||||||||||
| Primary Practice Address | 8528 GOLF RIDGE DR CHARLOTTE, NC 28277-8836 United States Phone: 917-686-6406 | Fax: | ||||||||||||
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