Individual
MR. CORNELIUS AL WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15805 BAYLIS ST, STE # 101, DETROIT, MI 48238-3915
(313) 341-1777
(313) 521-0228
Mailing address
5440 CASS AVE, STE # 1209, DETROIT, MI 48202-3668
(313) 942-2803
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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