Individual
MR. CHARLES DALTON WILSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12607 PENNING BLF, SAN ANTONIO, TX 78253-4351
(832) 690-8432
Mailing address
12607 PENNING BLF, SAN ANTONIO, TX 78253-4351
(832) 690-8432
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
67329
TX
Other
Enumeration date
02/08/2017
Last updated
09/06/2023
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