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1124246475
TERRY DWAYNE WILSON
FAYETTEVILLE, NC
NPI
1124246475
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-23
Last Update Date
2007-07-08
Business Address
Mr. TERRY DWAYNE WILSON Associate
3423 MELROSE RD # A
FAYETTEVILLE, NC 28304-1608
Phone number: 910-864-8739
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Mailing Address
Mr. TERRY DWAYNE WILSON Associate
978 BASSMAN LN APT 304
FAYETTEVILLE, NC 28314-2189
Phone number: 910-723-1898
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