person
Tracy C Wilson, MED
Professional Counselor in Carrollton, Georgia
NPI 1033256938

Tracy C Wilson is a Professional Counselor based in Carrollton, GA and is specialized in Professional. Tracy C Wilson practices in Carrollton, GA and has the professional credentials of MED. The NPI Number for Tracy C Wilson is 1033256938 and holds a License No. 2748 (Georgia).

The current practice location address for Tracy C Wilson is 215 Bradley St, Carrollton, GA and can be reached out via phone at 770-832-9140 and via fax at 770-832-3046.

Location: 215 Bradley St, Carrollton, GA, 30117-3217
person
Provider Profile Details
NPI Number
1033256938
Provider Name
Tracy C Wilson
Credential
MED
Provider Entity Type
Individual
Gender
Female
Address
215 Bradley St, Carrollton, GA, 30117-3217
Phone Number
770-832-9140
Fax Number
770-832-3046
Provider Enumeration Date
01/31/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
844101180A 05 GA
11643300 01 GA CAQH
institution
Provider Business Practice Location Address Details
Address
215 Bradley St
City
State
Zip
30117-3217
Phone Number
770-832-9140
Fax Number
770-832-3046
person
Provider Business Mailing Address Details
Address
215 Bradley St
City
State
Zip
30117-3217
Phone Number
770-832-9140
Fax Number
770-832-3046
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2748 (Georgia)
Definition
Definition to come...
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