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Madison Wilson
Mental Health Counselor in Tyler, Texas
NPI 1356119184

Madison Wilson is a Mental Health Counselor based in Tyler, TX and is specialized in Mental Health. Madison Wilson practices in Tyler, TX. The NPI Number for Madison Wilson is 1356119184 and holds a License No. 92816 (Texas).

The current practice location address for Madison Wilson is 16911 Old Bullard Road, Tyler, TX and can be reached out via phone at 903-871-3450.

Location: 16911 Old Bullard Road, Tyler, TX, 75703-0605
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356119184
Provider Name
Madison Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
16911 Old Bullard Road, Tyler, TX, 75703-0605
Phone Number
903-871-3450
Fax Number
Provider Enumeration Date
12/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
16911 Old Bullard Road
City
Tyler
State
Texas
Zip
75703
Phone Number
903-871-3450
Fax Number
person
Provider Business Mailing Address Details
Address
16911 Old Bullard Road
City
Tyler
State
Texas
Zip
75703
Phone Number
903-871-3450
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
92816 (Texas)
Definition
Definition to come...
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