Individual
MR. DOUGLAS ALAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
17224 VAN WAGONER RD, SPRING LAKE, MI 49456-9702
(231) 799-8182
(616) 296-2148
Mailing address
17224 VAN WAGONER RD, SPRING LAKE, MI 49456-9702
(231) 799-8182
(616) 296-2148
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012170
MI
Other
Enumeration date
10/15/2010
Last updated
12/03/2015
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