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Individual

JESSE E WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MHPP

Contact information

Practice address
1600 ALDERSGATE RD, SUITE 200, LITTLE ROCK, AR 72205-6614
(501) 661-0720
Mailing address
1600 ALDERSGATE RD, SUITE 200, LITTLE ROCK, AR 72205-6614
(501) 661-0720

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/02/2011
Last updated
12/02/2011
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