Dominique Marie Wilson, MA, LCPC, CRC Valid NPI

Individual provider · Professional Counselor · O Fallon, IL

NPI

1407345192

Type

Individual (Type 1)

Primary specialty

Professional Counselor (Counselor)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

101YP2500X

License number

180.012945 (IL)

Sex

Female

Sole proprietor

Yes

Enumerated

2018-05-08

Last updated

2020-08-11