NPI 1164630018

Earl Wilson, REVLMFT

Practitioner Marriage & Family Therapist Jackson, MS

Practice location

Address: 6205 Hanging Moss Rd, Jackson, MS 39206-2121
Phone: (601) 982-3997
Fax: (601) 982-8933
Mailing address: 706 Colonial Cir, Jackson, MS 39211-3208

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence 35001450 (IN)

Other Marriage & Family Therapist providers in Mississippi →

Registry record

NPI: 1164630018
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 May 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.