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Individual
MR. DALE WILSON
Active
Individual
MR. DALE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCSW - 33650
ID
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCSW - 33650
ID
101YM0800X
Mental Health Counselor
Primary
LCSW - 33650
ID
101YP1600X
Pastoral Counselor
LCSW - 33650
ID
Other
Enumeration date
02/18/2011
Last updated
08/10/2021
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