Individual
DR. JONATHAN RASHIED WILSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
6504 ELMWOOD AVE, PHILADELPHIA, PA 19142-2817
(267) 232-8383
Mailing address
6504 ELMWOOD AVE, PHILADELPHIA, PA 19142-2817
(267) 232-8383
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
Q3-0000199
DE
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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