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Charlie Isiah Wilson JR.
Mental Health Counselor in Conway, South Carolina
NPI 1538635115

Charlie Isiah Wilson JR. is a Mental Health Counselor based in Conway, SC and is specialized in Mental Health. Charlie Isiah Wilson JR. practices in Conway, SC. The NPI Number for Charlie Isiah Wilson JR. is 1538635115 and holds a License No. (South Carolina).

The current practice location address for Charlie Isiah Wilson JR. is 164 Waccamaw Medical Park Dr, Conway, SC and can be reached out via phone at 843-347-5060 and via fax at 843-347-3959.

Location: 164 Waccamaw Medical Park Dr, Conway, SC, 29526-8903
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538635115
Provider Name
Charlie Isiah Wilson JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
164 Waccamaw Medical Park Dr, Conway, SC, 29526-8903
Phone Number
843-347-5060
Fax Number
843-347-3959
Provider Enumeration Date
10/22/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
164 Waccamaw Medical Park Dr
City
Conway
State
South Carolina
Zip
29526-8903
Phone Number
843-347-5060
Fax Number
843-347-3959
person
Provider Business Mailing Address Details
Address
164 Waccamaw Medical Park Dr
City
Conway
State
South Carolina
Zip
29526-8903
Phone Number
843-347-5060
Fax Number
843-347-3959
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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