Provider Demographics
NPI:1336844158
Name:WILSON, RUTH C (LPC CAS)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:C
Last Name:WILSON
Suffix:
Gender:F
Credentials:LPC CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25807 WESTHEIMER PKWY STE 311
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5333
Mailing Address - Country:US
Mailing Address - Phone:713-408-9081
Mailing Address - Fax:
Practice Address - Street 1:25807 WESTHEIMER PKWY STE 311
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5333
Practice Address - Country:US
Practice Address - Phone:713-408-9081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional