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Individual
DAVID LEROY WILSON
Active
Individual
DAVID LEROY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT, M.DIV.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
IN
106H00000X
Marriage & Family Therapist
Primary
167720
KY
106H00000X
Marriage & Family Therapist
2012-012
KY
Other
Enumeration date
06/27/2013
Last updated
10/12/2016
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