Individual
CODY L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5452 HIGHWAY 105 W STE 103, CONROE, TX 77304-1403
(936) 520-9124
Mailing address
25335 BUDDE RD APT 921, SPRING, TX 77380-2319
(936) 222-1175
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
81173
TX
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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