Individual
MR. TIMOTHY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, NCC
Contact information
Practice address
1047 VISTA PARK DR STE A, FOREST, VA 24551-4362
(434) 616-2388
Mailing address
1047 VISTA PARK DR STE A, FOREST, VA 24551-4362
(434) 616-2388
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704012471
VA
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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