Individual provider · Type 1 NPI
Dominique Wilson
Professional Counselor · Chisago City, MN
NPI number
1083369490
Active
Practice location
11185 Lake Blvd Ste 205
Chisago City, MN 55013-9814
Mailing address
17566 Xingu St NE
Columbus, MN 55025-8869
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
2 other providers at this address
Other professional counselor providers in Chisago City
About NPI 1083369490
Dominique Wilson's National Provider Identifier is 1083369490, issued on Feb 14, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chisago City, MN. The record was last updated on Feb 14, 2022.