Wilson, Kristine D

Wilson, Kristine D is an sole proprietor health care provider with primary practice located at 368 Courthouse Rd Ste D , Gulfport MS 39507-1854. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wilson, Kristine D can be contacted via phone (228) 341-1079.

Contact Information

Primary practice address
368 Courthouse Rd Ste D Gulfport MS 39507-1854
Phone: (228) 341-1079
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2131 Mississippi

Profile Details

NPI number 1346775863
LBN Legal business name Wilson, Kristine D
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 21st, 2017
Last updated Sep 7th, 2024 - about 2 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 1346775863 NPPES
Mississippi MEDICAID 05278341

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