Individual
WILSON ESPINAL PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
185 CHAUCER PKWY, FAYETTEVILLE, GA 30214-7150
(347) 299-7540
Mailing address
185 CHAUCER PKWY, FAYETTEVILLE, GA 30214-7150
(347) 299-7540
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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