Most Relevant Information
Provider Data
| NPI Number: | 1003424078 |
| Provider Name: | MARQUITA LACHETTE WILSON M.ED., CMHT, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/16/2020 |
| Last Updated: | 11/10/2021 |
Provider Practice Location
125 RIVER RIDGE CIR
CHOCTAW
MS
393501009
Practice Location Phone/Fax
| Phone: | 6016637917 |
| Fax: | 6016637696 |
Provider Mailing Location
125 RIVER RIDGE CIR
CHOCTAW
MS
393501009
Provider Mailing Phone/Fax
| Phone: | 6016637917 |
| Fax: | 6016637696 |