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MR. BENJAMIN RUSSELL WILSON LLPC
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1093257461
Individual Registrant:MR. BENJAMIN RUSSELL WILSON LLPC
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
6461 DAWN DR BELLEVUE, MI 49021-8411 US
Tel: 269-986-2844 Fax: --
Tel: 269-986-2844 Fax: --
Contact information for business:
6461 DAWN DR. BELLEVUE, MI 49021 US
Tel: 269-986-2844 Fax: --
Tel: 269-986-2844 Fax: --
Registration Information:
NPI: 1093257461
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional | MI | 6401015351 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
