Individual
MR. LAWRENCE EDWARD WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NACAII, LADACII,
Contact information
Practice address
1548 POPLAR AVE, MEMPHIS, TN 38104-2432
(901) 277-6101
(901) 729-2933
Mailing address
3543 PHILSDALE AVE, MEMPHIS, TN 38111-5450
(901) 277-6101
(901) 729-2933
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
016414
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LDC0000000344
TN
Other
Enumeration date
06/28/2017
Last updated
06/28/2017
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