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1164630018
EARL WILSON
JACKSON, MS
NPI
1164630018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: IN 35001450)
Enumeration Date
2007-05-21
Last Update Date
2007-07-08
Business Address
Mr. EARL WILSON Rev, LMFT
6205 HANGING MOSS RD
JACKSON, MS 39206-2121
Phone number: 601-982-3997
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Mailing Address
Mr. EARL WILSON Rev, LMFT
706 COLONIAL CIR
JACKSON, MS 39211-3208
Phone number: 601-899-5827
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