Individual
MR. DEREK JAMES WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
360 BLOOMFIELD AVE STE 301, WINDSOR, CT 06095-2700
(860) 471-3819
Mailing address
260 CARRIAGE CROSSING LN, MIDDLETOWN, CT 06457-5864
(860) 471-3819
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003206
CT
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
12/27/2013
Last updated
10/02/2018
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