Individual
NATHAN RYAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLMHP
Contact information
Practice address
4732 S 131ST ST, OMAHA, NE 68137-1822
(402) 697-3923
(402) 697-3924
Mailing address
4732 S 131ST ST, OMAHA, NE 68137-1822
(402) 697-3923
(402) 697-3924
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9109
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47082303526
—
NE
Enumeration date
04/14/2010
Last updated
04/14/2010
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