Individual provider · Type 1 NPI

Kelley Wilson

Mental Health Counselor · Bradenton, FL

NPI number 1104244474 Active

Practice location

5131 Manatee Ave W
Bradenton, FL 34209-3740

Call (941) 792-0802 Map

Mailing address

7406 Loblolly Bay Trl
Lakewood Ranch, FL 34202-4167

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMH7200 (FL)

Mental Health Counselor: Definition to come...

4 other providers at this address

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About NPI 1104244474

Kelley Wilson's National Provider Identifier is 1104244474, issued on Apr 2, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bradenton, FL. The record was last updated on Apr 2, 2014.