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1023318276
JACOB R WILSON
ROCKFORD, IL
NPI
1023318276
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-10-21
Last Update Date
2014-07-31
Business Address
Mr. JACOB R WILSON BA
8616 NORTHERN AVE
ROCKFORD, IL 61107-5309
Phone number: 815-391-1000
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Mailing Address
Mr. JACOB R WILSON BA
8616 NORTHERN AVE
ROCKFORD, IL 61107-5309
Phone number: 815-391-1000
Copy
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