Individual
AARON WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1453 16TH STREET, SANTA MONICA, CA 90404
(310) 264-6646
Mailing address
1453 16TH ST, SANTA MONICA, CA 90404-2715
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/03/2017
Last updated
07/03/2017
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