Individual
MR. MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
914 N 2ND ST APT 8, SAINT CHARLES, MO 63301-2070
(314) 240-0208
Mailing address
6914 PINE RIDGE DR, SAINT LOUIS, MO 63121-2734
(314) 240-0208
(708) 778-7917
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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