Provider Demographics
NPI:1598400384
Name:WILSON, AALIYAH (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:AALIYAH
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 BRAWLEY SCHOOL RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8154
Mailing Address - Country:US
Mailing Address - Phone:704-659-4707
Mailing Address - Fax:
Practice Address - Street 1:862 BRAWLEY SCHOOL RD STE 202
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8154
Practice Address - Country:US
Practice Address - Phone:704-659-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-05
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12420A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist