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1205303740
JOHNNIE WILLIE WILSON
CARTERSVILLE, GA
NPI
1205303740
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-11-01
Last Update Date
2018-11-01
Business Address
JOHNNIE WILLIE WILSON
218 STONEWALL ST
CARTERSVILLE, GA 30120-3628
Phone number: 770-386-1907
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Mailing Address
JOHNNIE WILLIE WILSON
218 STONEWALL ST
CARTERSVILLE, GA 30120-3628
Phone number: 770-386-1907
Copy
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