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Individual
JEFF WILSON
Active
Individual
JEFF WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60391036
WA
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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