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1902089972
MICHAEL LAWRENCE WILSON
TACOMA, WA
NPI
1902089972
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2007-12-12
Last Update Date
2007-12-12
Business Address
MR. MICHAEL LAWRENCE WILSON AA
3834 S 19TH ST
TACOMA, WA 98405-2016
Phone number: 253-396-5901
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Mailing Address
MR. MICHAEL LAWRENCE WILSON AA
5623 N 49TH ST
RUSTON, WA 98407-3014
Phone number: 235-548-9728
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