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Individual

MR. LEVEN WILSON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7920 GUNN HWY, TAMPA, FL 33626-1613
(813) 997-9893
Mailing address
6350 W MACLAURIN DR, TAMPA, FL 33647-1164
(813) 455-1826

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
104100000X
Social Worker
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
11/20/2008
Last updated
05/06/2021
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