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Individual

MR. JOE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.P.C.

Contact information

Practice address
144 PIERCE AVENUE, MACON, GA 31204
(478) 475-4608
(478) 476-8397
Mailing address
144 PIERCE AVENUE, MACON, GA 31204
(478) 475-4608
(478) 476-8397

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003234
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC003234
LICENSED PROFESSIONAL COUNSELOR
GA
Enumeration date
06/23/2011
Last updated
02/24/2015
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