Individual
MR. TERRY DWAYNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASSOCIATE
Contact information
Practice address
3423 MELROSE RD # A, FAYETTEVILLE, NC 28304-1608
(910) 864-8739
(910) 864-8222
Mailing address
978 BASSMAN LN APT 304, FAYETTEVILLE, NC 28314-2189
(910) 723-1898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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