Individual
ERNEST DANIEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 COLONIAL DR, IMPACT, COLUMBIA, SC 29203-6827
(803) 898-8133
(803) 898-2194
Mailing address
211 STUCAWA DR, COLUMBIA, SC 29210-6516
(803) 561-0345
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
SC
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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