NPI 1073953253

Shatisha Matrice Wilson, MSLPCRPTSACS

Practitioner Professional Counselor Martinez, GA

Practice location

Address: 4210 Columbia Rd STE 13b, Martinez, GA 30907-0445
Phone: (706) 496-2856
Fax: (762) 333-2872
Mailing address: PO Box 3134, Evans, GA 30809-0079

Registered specialties (2)

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence LPC008626 (GA)

Other Counselor providers in Georgia →

Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence PC8041 (SC)

Registry record

NPI: 1073953253
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Jul 2013
Record last updated: 3 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.