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Marissa Nicole Wilson
Mental Health Counselor in Daly City, California
NPI 1366056947

Marissa Nicole Wilson is a Mental Health Counselor based in Daly City, CA and is specialized in Mental Health. Marissa Nicole Wilson practices in Daly City, CA. The NPI Number for Marissa Nicole Wilson is 1366056947 and holds a License No. (California).

The current practice location address for Marissa Nicole Wilson is 227 Buena Vista Ave, Daly City, CA and can be reached out via phone at 951-505-1991.

Location: 227 Buena Vista Ave, Daly City, CA, 94015-2120
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366056947
Provider Name
Marissa Nicole Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
227 Buena Vista Ave, Daly City, CA, 94015-2120
Phone Number
951-505-1991
Fax Number
Provider Enumeration Date
09/01/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
UCR560M87615 01 CA ANTHEM BLUECROSS
institution
Provider Business Practice Location Address Details
Address
227 Buena Vista Ave
City
Daly City
State
California
Zip
94015-2120
Phone Number
951-505-1991
Fax Number
person
Provider Business Mailing Address Details
Address
227 Buena Vista Ave
City
Daly City
State
California
Zip
94015-2120
Phone Number
951-505-1991
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(California)
Definition
Definition to come...
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