Individual
NICHOLAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2869 W TANNER RANCH RD, QUEEN CREEK, AZ 85142-4724
(256) 510-6800
Mailing address
2869 W TANNER RANCH RD, QUEEN CREEK, AZ 85142-4724
(256) 510-6800
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/15/2022
Last updated
09/24/2022
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