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1245806439
WILLIE J WILSON
BALTIMORE, MD
NPI
1245806439
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD AC-1150)
Enumeration Date
2021-05-28
Last Update Date
2021-05-28
Business Address
Mr. WILLIE J WILSON CAC-AD
3111 CLIFTON AVE
BALTIMORE, MD 21216-2734
Phone number: 443-271-2874
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Mailing Address
Mr. WILLIE J WILSON CAC-AD
3916 ANNELLEN RD
BALTIMORE, MD 21215-7215
Phone number: 443-271-2874
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