Individual
MR. ELLIS WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2331 CANAL ST, NEW ORLEANS, LA 70119-6503
(844) 239-3737
Mailing address
3868 GALLATIN ST, NEW ORLEANS, LA 70114-5022
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/02/2016
Last updated
12/03/2018
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