TERRY SHAWN WILSON

DAYTON, OH
NPI1205498433
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  16811)
Enumeration Date2019-07-09
Last Update Date2019-07-09
Business Address
TERRY SHAWN WILSON
2611 WAYNE AVE
DAYTON, OH 45420-1833
Phone number: 937-256-7801
Mailing Address
TERRY SHAWN WILSON
8581 LYONS GATE WAY APT C
MIAMISBURG, OH 45342-7837
Phone number: 614-663-7960