| Michele L Wilson | |
|
400 Village Square Xing Suite 2 Palm Beach Gardens FL 33410-3227 | |
| (561) 308-0814 | |
| (561) 444-4444 |
| Full Name | Michele L Wilson |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 400 Village Square Xing, Palm Beach Gardens, Florida |
| Authorized Official Name and Position | Michele L Wilson (PROVIDER & OWNER) |
| Authorized Official Contact | 5613080814 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michele L Wilson 6054 Hollywood Street Jupiter FL 33458-6724 Ph: (561) 308-0814 | Michele L Wilson 400 Village Square Xing Suite 2 Palm Beach Gardens FL 33410-3227 Ph: (561) 308-0814 |
| NPI Number | 1205231404 |
|---|---|
| Provider Enumeration Date | 10/30/2014 |
| Last Update Date | 10/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205231404 | NPI | - | NPPES |
| MH12108 | Other | FL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH12108 (Florida) | Primary |
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