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Dominique M Wilson, LCPC
Mental Health Counselor in Marion, Illinois
NPI 1225584188

Dominique M Wilson is a Mental Health Counselor based in Marion, IL and is specialized in Mental Health. Dominique M Wilson practices in Marion, IL and has the professional credentials of LCPC. The NPI Number for Dominique M Wilson is 1225584188 and holds a License No. 180.011802 (Illinois).

The current practice location address for Dominique M Wilson is 1616 W Main St Ste 503, Marion, IL and can be reached out via phone at 618-703-3038.

Location: 1616 W Main St Ste 503, Marion, IL, 62959-1146
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225584188
Provider Name
Dominique M Wilson
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
1616 W Main St Ste 503, Marion, IL, 62959-1146
Phone Number
618-703-3038
Fax Number
Provider Enumeration Date
08/31/2016
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1616 W Main St Ste 503
City
Marion
State
Illinois
Zip
62959-1146
Phone Number
618-703-3038
Fax Number
person
Provider Business Mailing Address Details
Address
1616 W Main St Ste 503
City
Marion
State
Illinois
Zip
62959-1146
Phone Number
618-703-3038
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
180.011802 (Illinois)
Definition
Definition to come...
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