Individual
RUTH BERNICE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1110 W 5TH AVE, GARY, IN 46402-1723
(219) 885-4264
Mailing address
1110 W 5TH AVE, GARY, IN 46402-1723
(219) 885-4264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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