Individual
ANDREW TYLER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 COLLEGE AVE STE 250, SANTA ROSA, CA 95404-3952
(707) 568-2300
Mailing address
PO BOX 4, SANTA ROSA, CA 95402-0004
(415) 847-1534
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
152691
CA
Other
Enumeration date
05/15/2020
Last updated
07/03/2025
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