Dominique Wilson's National Provider Identifier (NPI) Details
Dominique Wilson, LCPC
NPI: 1225584188
Enumeration Date: 2016-08-31
Last updated: 2024-03-05
Sole Proprietor: NO
Status: active
Postal Address: 1616 W MAIN ST STE 503, MARION, IL
Phone: 618-703-3038
Primary Practice Address: 1616 W MAIN ST STE 503, MARION, IL
Practice's phone: 618-703-3038