Individual
MICHAEL D WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,MDIV,CEAP,LPC
Contact information
Practice address
3 ALEXANDRA LN, LONG VALLEY, NJ 07853-3458
(908) 876-5693
Mailing address
3 ALEXANDRA LN, LONG VALLEY, NJ 07853-3458
(908) 876-5693
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00053700
NJ
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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