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Individual

MR. CHARLES EMMONS WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA LMFT

Contact information

Practice address
511NORTH 12TH ST, RIVERTON, WY 82501
(307) 857-6685
Mailing address
62 RIDGE RD, LANDER, WY 82520-9788
(307) 330-4635

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-111
WY

Other

Enumeration date
06/30/2008
Last updated
07/24/2008
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