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1144201633
LOUIS WILSON
ALBUQUERQUE, NM
NPI
1144201633
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: NM 1319)
Enumeration Date
2005-11-10
Last Update Date
2019-05-02
Business Address
LOUIS WILSON
8300 CONSTITUTION AVE NE
ALBUQUERQUE, NM 87110-7613
Phone number: 505-291-2134
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Mailing Address
LOUIS WILSON
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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