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Individual

MR. J PATRICK WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA LMFT LPC-S

Contact information

Practice address
322 HEYMANN BLVD, BLDG. B, STE. 4, LAFAYETTE, LA 70503-2465
(337) 233-1775
(337) 233-1775
Mailing address
PO BOX 53527, LAFAYETTE, LA 70505-3527
(337) 233-1775
(337) 233-1775

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2653
LA
106H00000X
Marriage & Family Therapist
8
LA

Other

Enumeration date
05/16/2006
Last updated
01/29/2015
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