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Contact Information

HOLLY K WILSON
107 SUNSET LOOP
MESCALERO, NM88340
 Phone: 575-464-4338
 Fax: 575-464-4331
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for HOLLY K WILSON · (Female)

NPI # 1245557958
Status Active
Credentials
Entity Individual
Enumeration date 04/21/2010
Last updated 04/21/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 0119501
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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