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Individual

BRIAN WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5406 GATEWAY CTR, SUITE A, FLINT, MI 48507-3900
(810) 358-1529
Mailing address
1408 GRANT CT, LAPEER, MI 48446-1278
(810) 358-1529

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401012081
MI

Other

Enumeration date
08/31/2016
Last updated
08/31/2016
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