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Mary Wilson
Counselor in Bolivar, Tennessee
NPI 1578662532

Mary Wilson is a Counselor based in Bolivar, TN. Mary Wilson practices in Bolivar, TN. The NPI Number for Mary Wilson is 1578662532 and holds a License No. (Tennessee).

The current practice location address for Mary Wilson is 10710 Old Highway 64, Bolivar, TN and can be reached out via phone at 731-658-6113 and via fax at 731-658-6165.

Location: 10710 Old Highway 64, Bolivar, TN, 38008-2858
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578662532
Provider Name
Mary Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
10710 Old Highway 64, Bolivar, TN, 38008-2858
Phone Number
731-658-6113
Fax Number
731-658-6165
Provider Enumeration Date
09/22/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
57436800 05 TN
institution
Provider Business Practice Location Address Details
Address
10710 Old Highway 64
City
Bolivar
State
Tennessee
Zip
38008-3587
Phone Number
731-658-6113
Fax Number
731-658-6165
person
Provider Business Mailing Address Details
Address
10710 Old Highway 64
City
Bolivar
State
Tennessee
Zip
38008-3587
Phone Number
731-658-6113
Fax Number
731-658-6165
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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