Individual
EARTHERN HERMAN WILSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
740 BECK AVE, FAIRFIELD, CA 94533-4440
(707) 784-6570
Mailing address
2918 WATERMAN CT, FAIRFIELD, CA 94534-2973
(707) 479-5037
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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