Individual
JASON SCOTT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1225 W HUDSON RD, TELEHEALTH ONLY, ROGERS, AR 72756
(479) 899-2176
Mailing address
PO BOX 2272, HARRISON, AR 72602-2272
(479) 899-2176
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A1703190
AR
101YP2500X
Professional Counselor
Primary
P2112003
AR
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
12/03/2017
Last updated
02/22/2024
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