Most Relevant Information
Provider Data
| NPI Number: | 1003006362 |
| Provider Name: | MICHELE MABRY WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/01/2007 |
| Last Updated: | 08/01/2007 |
Provider Practice Location
411 30TH ST
#314
OAKLAND
CA
946093301
Practice Location Phone/Fax
| Phone: | 5102734200 |
| Fax: |
Provider Mailing Location
5674 STONERIDGE DR
# 116
PLEASANTON
CA
945888500
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |