Individual
MR. MICHAEL TYLER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADT
Contact information
Practice address
212 BLUE BALL AVE, ELKTON, MD 21921-5222
(410) 620-6077
(410) 620-6081
Mailing address
212 BLUE BALL AVE, ELKTON, MD 21921-5222
(410) 620-6077
(410) 620-6081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MD
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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