Individual
WILSON ERIC JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MACM
Contact information
Practice address
3038 YORKTOWN DR, BATON ROUGE, LA 70808-3471
(225) 572-2908
Mailing address
3038 YORKTOWN DR, BATON ROUGE, LA 70808-3471
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
LA
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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