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Individual

MICHAEL WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
211 E LOGAN ST STE 201, CALDWELL, ID 83605-4883
(208) 454-1480
(208) 268-8444
Mailing address
1221 ABRAMS RD STE 325, RICHARDSON, TX 75081-5579

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/14/2018
Last updated
12/18/2025
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Product
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