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Mr. Anthony L Wilson, CRM
Peer Specialist in Coos Bay, Oregon
NPI 1396201216

Anthony L Wilson is a Peer Specialist based in North Bend, OR. Anthony L Wilson practices in Coos Bay, OR and has the professional credentials of CRM. The NPI Number for Anthony L Wilson is 1396201216 and holds a License No. 19-CRM-044 (Oregon).

The current practice location address for Anthony L Wilson is 155 S Empire Blvd, Coos Bay, OR and can be reached out via phone at 541-256-4686. You can also correspond with Anthony L Wilson through the mailing address at 1942 SHERIDAN AVE, NORTH BEND, OR - 97459-3416 (mailing address contact number: 541-256-4686).

Location: 155 S Empire Blvd, Coos Bay, OR, 97459-3416
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396201216
Provider Name
Anthony L Wilson
Credential
CRM
Provider Entity Type
Individual
Gender
Male
Address
155 S Empire Blvd, Coos Bay, OR, 97459-3416
Phone Number
541-256-4686
Fax Number
Provider Enumeration Date
02/15/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
19-CRM-044 01 OR MHACBO
institution
Provider Business Practice Location Address Details
Address
155 S Empire Blvd
City
Coos Bay
State
Oregon
Zip
97420-3374
Phone Number
541-256-4686
Fax Number
person
Provider Business Mailing Address Details
Address
155 S Empire Blvd
City
Coos Bay
State
Oregon
Zip
97420-3374
Phone Number
541-256-4686
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
19-CRM-044 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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