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Individual

MR. MOSE WILSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1455 N MAIN ST, APT C-125, LAS VEGAS, NV 89101-1092
(702) 742-1707
Mailing address
1455 N MAIN ST, APT C-125, LAS VEGAS, NV 89101-1092
(702) 742-1707

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45-3558217
NV
Enumeration date
05/21/2012
Last updated
05/21/2012
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