Tyquine Wilson

NPI #1891168134 in Lithonia, Georgia

Provider Information

NPI Number: 1891168134
Entity Type: Individual
Name: Tyquine Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Enumeration Date: Nov 9, 2015
Last Updated: Nov 9, 2015

Practice Location

Address: 6382 LAUREL GREEN DR
City: Lithonia
State: Georgia
ZIP Code: 30058-3111
Phone: (404) 647-9756

Specialties & Taxonomy Codes

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

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