Individual provider · Type 1 NPI

Jacqueline Ellen Wilson, MAQMHP

Mental Health Counselor · Waterloo, IL

NPI number 1972717205 Active

Practice location

988 N Illinois Route 3
Waterloo, IL 62298-1000

Mailing address

17 W Waters Edge Dr
Belleville, IL 62221-7801

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1972717205

Jacqueline Ellen Wilson, MAQMHP's National Provider Identifier is 1972717205, issued on May 9, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Waterloo, IL. The record was last updated on Jul 8, 2007.