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1982949988
KEITH L WILSON
SPRINGFIELD, MO
NPI
1982949988
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: MO 2012037415)
Enumeration Date
2012-12-01
Last Update Date
2015-02-17
Business Address
Mr. KEITH L WILSON MS, LPC
1330 E CHERRY ST # 12
SPRINGFIELD, MO 65802-3429
Phone number: 417-761-9598
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Mailing Address
Mr. KEITH L WILSON MS, LPC
1330 E CHERRY ST # 12
SPRINGFIELD, MO 65802-3429
Phone number: 417-761-9598
Copy
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