Individual
JOSHUA DAVID WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(765) 617-8040
Mailing address
1015 MICHIGAN AVE, LOGANSPORT, IN 46947-1526
(765) 617-8040
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003482A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39003482A
—
IN
Enumeration date
02/02/2022
Last updated
02/02/2022
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