Provider Information for 1457531519
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Mr. STEVEN ALEXANDER WILSON LPC, LCAS, NCC,
Sex: Male
NPI: 1457531519
Last Updated: 2016-04-29
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1457531519 | ||||||||||||
| Enumeration Date | 2007-11-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3719 W MARKET ST SUITE B GREENSBORO, NC 27403-1588 United States Phone: 336-547-6361 | Fax:336-547-6364 | ||||||||||||
| Primary Practice Address | 3719 W MARKET ST SUITE B GREENSBORO, NC 27403-1588 United States Phone: 336-547-6361 | Fax:336-547-6364 | ||||||||||||
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