Mary Kathleen Wilson

NPI #1164642997 in Pittsfield, Illinois

Provider Information

NPI Number: 1164642997
Entity Type: Individual
Name: Mary Kathleen Wilson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Enumeration Date: Apr 26, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 121 SOUTH MADISON STREET
Address 2: MENTAL HEALTH CENTERS OF WESTERN ILLINOIS
City: Pittsfield
State: Illinois
ZIP Code: 62363
Phone: (217) 285-4436

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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