Individual
DAVID LEROY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT, M.DIV.
Contact information
Practice address
975 N BARDSTOWN RD, MOUNT WASHINGTON, KY 40047-7602
(502) 822-6861
Mailing address
975 N BARDSTOWN RD, MOUNT WASHINGTON, KY 40047-7602
(502) 822-6861
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
IN
106H00000X
Marriage & Family Therapist
Primary
167720
KY
106H00000X
Marriage & Family Therapist
2012-012
KY
Other
Enumeration date
06/27/2013
Last updated
10/12/2016
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