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Individual
IAN THOMAS WILSON
Active
Individual
IAN THOMAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, AAC, CDPT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60199789
WA
101YM0800X
Mental Health Counselor
Primary
CG60199789
WA
390200000X
Student in an Organized Health Care Education/Training Program
CO60341690
WA
Other
Enumeration date
01/20/2011
Last updated
04/25/2013
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