Wilson, Kimberly Lannette

Wilson, Kimberly Lannette is an individual health care provider with primary practice located at 2015 Ayrsley Town Blvd Suite 202, Charlotte NC 28273-4067. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Wilson, Kimberly Lannette can be contacted via phone (704) 280-8502.

Contact Information

Primary practice address
2015 Ayrsley Town Blvd Suite 202 Charlotte NC 28273-4067
Phone: (704) 280-8502
Fax: (800) 858-2194
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 785 Tennessee
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101006188 Michigan
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MFT000954 Georgia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1303 North Carolina

Profile Details

NPI number 1265587430
LBN Legal business name Wilson, Kimberly Lannette
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Dec 11th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265587430 NPPES
Georgia MEDICAID 090073276A

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