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Individual
MARCUS JAY WILSON
Active
Individual
MARCUS JAY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
NLC.0106799
CO
Other
Enumeration date
04/01/2017
Last updated
04/01/2017
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