Individual provider · Type 1 NPI
Deitra Wilson
Mental Health Counselor · Beachwood, OH
NPI number
1700697919
Active
Practice location
24100 Chargin Blvd, Suite 250
Beachwood, OH 44122
Fax (440) 264-1990
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | C.2406416-TRNE (OH) |
Mental Health Counselor: Definition to come...
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About NPI 1700697919
Deitra Wilson's National Provider Identifier is 1700697919, issued on Jan 16, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Beachwood, OH. The record was last updated on Jan 16, 2025.