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Individual

DR. PAUL THOMAS WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHC, LMFT, LSW

Contact information

Practice address
307 SIMPSON ST, GREENCASTLE, IN 46135-0066
(765) 658-6776
Mailing address
PO BOX 792, GREENCASTLE, IN 46135-0792
(765) 658-6776

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000877A
IN
104100000X
Social Worker
33002523A
IN
106H00000X
Marriage & Family Therapist
35001054A
IN

Other

Enumeration date
05/23/2007
Last updated
11/12/2009
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