Wilson Standard Wellness
Counselor, Professional in Edwardsville, IL. Organization (NPI-2).
NPI number1104776376
StatusActive
Last updated in NPPESJan 29, 2026
Details
- NPI
- 1104776376
- Entity type
- Organization (NPI-2)
- Legal business name
- Wilson Standard Wellness
- Organization subpart
- No
- Enumeration date
- Jan 29, 2026
- Certification date
- Jan 29, 2026
- Last updated
- Jan 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
100 N Main St Ste 12Edwardsville, IL 62025-1981
Phone 618-513-9744
Mailing address
100 N Main St Ste 12Edwardsville, IL 62025-1981
Authorized official
Kaitlyn Wilson
Owner/Therapist
6185139744
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