Provider Demographics
NPI:1730963570
Name:WILSON, KARON JANET
Entity type:Individual
Prefix:MS
First Name:KARON
Middle Name:JANET
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARON
Other - Middle Name:J E
Other - Last Name:KABA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:925 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4409
Mailing Address - Country:US
Mailing Address - Phone:201-658-8737
Mailing Address - Fax:
Practice Address - Street 1:925 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4409
Practice Address - Country:US
Practice Address - Phone:201-658-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FA00037200101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor