JEFF WILSON

SHELTON, WA
NPI1235515776
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP60391036)
Enumeration Date2015-08-06
Last Update Date2015-08-06
Business Address
-- JEFF WILSON CDP
611 W COTA ST
SHELTON, WA 98584-2241
Phone number: 360-426-5654
Mailing Address
-- JEFF WILSON CDP
611 W COTA ST
SHELTON, WA 98584-2241
Phone number: 360-426-5654
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