Individual
DR. DONALD LESTER WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2121 LAKE AVE, VA NIHCS, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1481
Mailing address
726 WEST SUPERIOR STREET, FORT WAYNE, IN 46802-1017
(260) 615-1173
(260) 460-1481
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
20041034A
IN
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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