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1811421084
JERWIN JERMAINE WILSON
SHREVEPORT, LA
NPI
1811421084
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-04-14
Last Update Date
2017-04-14
Business Address
-- JERWIN JERMAINE WILSON
7505 PINES RD
SHREVEPORT, LA 71129-3935
Phone number: 318-562-3707
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Mailing Address
-- JERWIN JERMAINE WILSON
6057 FOX CHASE TRL
SHREVEPORT, LA 71129-3540
Phone number: 318-436-1022
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