NPI 1194360248

Gerald Lee Wilson

Practitioner Peer Specialist Ontario, CA

Practice location

Address: 2940 Inland Empire Blvd, Ontario, CA 91764-4898
Phone: (909) 458-1335

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1194360248
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Nov 2019
Record last updated: 13 Nov 2019

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.