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1114320611
ANTWAIN WILSON
LANCASTER, CA
NPI
1114320611
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA IMF73683)
Enumeration Date
2014-09-29
Last Update Date
2014-09-29
Business Address
-- ANTWAIN WILSON
5300 W AVENUE I
LANCASTER, CA 93536-8312
Phone number: 661-940-4052
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Mailing Address
-- ANTWAIN WILSON
5300 W AVENUE I
LANCASTER, CA 93536-8312
Phone number: 661-940-4052
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