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1609396233
FREDRICK WILSON
SHREVEPORT, LA
NPI
1609396233
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-06-24
Last Update Date
2022-07-21
Business Address
FREDRICK WILSON
4601 N MARKET ST
SHREVEPORT, LA 71107-2971
Phone number: 318-424-8735
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Mailing Address
FREDRICK WILSON
PO BOX 5
RODESSA, LA 71069-0005
Phone number: 318-223-4665
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