Wilson, Tia

Wilson, Tia is an sole proprietor health care provider with primary practice located at 1726 Kingsley Ave , Orange Park FL 32073. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wilson, Tia can be contacted via phone (904) 278-5659.

Contact Information

Primary practice address
1726 Kingsley Ave Orange Park FL 32073
Phone: (904) 278-5659
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X IMH6626 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH12025 Florida

Profile Details

NPI number 1245662832
LBN Legal business name Wilson, Tia
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 6th, 2013
Last updated Jun 29th, 2018 - about 8 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.

Request for update

Popular Providers