Provider Information for 1952481400
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KELLI LYNN WILSON LMFT
Other Names:Former Name:KELLI LYNN WILSON-YOUNG LMFTSex: Female
NPI: 1952481400
Last Updated: 2022-03-16
Certification Date: 2022-03-16
Certification Date: 2022-03-16
Details
| Name | Value | ||||||||||||
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| NPI | 1952481400 | ||||||||||||
| Enumeration Date | 2006-10-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1247 AIRPORT ROAD CLARENDON, VT 05759 United States Phone: 802-773-3620 | Fax: | ||||||||||||
| Primary Practice Address | 1247 AIRPORT ROAD CLARENDON, VT 05759 United States Phone: 802-773-3620 | Fax: | ||||||||||||
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