Individual
DR. JONATHAN B WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LMFT-S
Contact information
Practice address
5130 GOODWIN AVE, DALLAS, TX 75206-6205
(972) 638-7485
Mailing address
5130 GOODWIN AVE, DALLAS, TX 75206-6205
(972) 638-7485
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203636
TX
106H00000X
Marriage & Family Therapist
LMFT10000178
MA
Other
Enumeration date
11/28/2011
Last updated
08/05/2024
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