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GLENN JAY WILSON

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1245672609

Individual Registrant:
 GLENN JAY WILSON 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
267 6TH ST  MEEKER, CO 81641 US
Tel: 970-878-5112  Fax: 970-878-4315

Contact information for business:
515 28 3/4 RD BLDG A GRAND JUNCTION, CO 81501-5016 US
Tel: 970-683-7107  Fax: 970-683-7167

Registration Information:
NPI: 1245672609
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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