Individual
BRADFORD TAYLOR WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 E SPRING ST, COOKEVILLE, TN 38501-5066
(615) 419-3863
Mailing address
606 E SPRING ST, COOKEVILLE, TN 38501-5066
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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