Provider Demographics
NPI:1801916879
Name:WILSON, MARGARET M (PHD, LPCC)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:M
Last Name:WILSON
Suffix:
Gender:F
Credentials:PHD, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:81 CANYON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANDIA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:87047-8509
Mailing Address - Country:US
Mailing Address - Phone:505-280-6612
Mailing Address - Fax:505-294-9282
Practice Address - Street 1:5600 WYOMING BLVD NE
Practice Address - Street 2:SUITE 240
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3149
Practice Address - Country:US
Practice Address - Phone:505-280-6612
Practice Address - Fax:505-294-9282
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM005518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional