Individual
MR. KARON R WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
LC6217
MD
101YP2500X
Professional Counselor
Primary
LC6217
MD
Other
Enumeration date
10/25/2012
Last updated
03/12/2015
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