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MR. BENJAMIN RUSSELL WILSON LLPC

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1093257461

Individual Registrant:
MR. BENJAMIN RUSSELL WILSON LLPC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
6461 DAWN DR  BELLEVUE, MI 49021-8411 US
Tel: 269-986-2844  Fax: --

Contact information for business:
6461 DAWN DR.  BELLEVUE, MI 49021 US
Tel: 269-986-2844  Fax: --

Registration Information:
NPI: 1093257461
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
MI6401015351

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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