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1386852143
TERRY LAMONT WILSON
LOS ANGELES, CA
NPI
1386852143
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-17
Last Update Date
2007-07-08
Business Address
-- TERRY LAMONT WILSON
3741 STOCKER ST STE 210
LOS ANGELES, CA 90008-5109
Phone number: 323-298-5651
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Mailing Address
-- TERRY LAMONT WILSON
1117 W 45TH ST
LOS ANGELES, CA 90037-2406
Phone number: 323-298-5651
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