Individual
JONATHAN EARL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHPP
Contact information
Practice address
2718 S ARCH ST, LITTLE ROCK, AR 72206-6529
(501) 551-1201
(501) 615-8721
Mailing address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7117-M
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/27/2010
Last updated
12/09/2021
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