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Individual
MR. TIMOTHY WILSON
Active
Individual
MR. TIMOTHY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, NCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704012471
VA
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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