Individual
MR. JAMES VERNON WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., L.I.S.A.C.
Contact information
Practice address
2123 W CHAMBERS ST, PHOENIX, AZ 85041-3720
(602) 276-5653
Mailing address
2123 W CHAMBERS ST, PHOENIX, AZ 85041-3720
(602) 276-5653
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11800
AZ
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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