Individual
MR. PAUL GREGORY WILSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHCA
Contact information
Practice address
4908 W SAINT CHARLES AVE, LAKE CHARLES, LA 70605-6756
(337) 446-5510
Mailing address
5534 SAINT JOE RD, FORT WAYNE, IN 46835-3328
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC61675851
WA
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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