Individual
KELDON OLIVER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2236 BROOK DR, KALAMAZOO, MI 49048-2806
(269) 492-7205
Mailing address
1800 RING RD S APT 6321, KALAMAZOO, MI 49008-1002
(517) 213-3527
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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