Individual
LEON M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
307 LAFAYETTE BLVD STE 202, FREDERICKSBURG, VA 22401-6079
(703) 915-9526
(240) 595-6187
Mailing address
PO BOX 297, HARTWOOD, VA 22471-0297
(703) 915-9526
(240) 595-6187
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701003698
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010090687
—
VA
Enumeration date
01/16/2007
Last updated
01/22/2021
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