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Mr. Tyrolia Dejuan Wilson
Addiction (Substance Use Disorder) Counselor in Kansas City, Kansas
NPI 1588194450

Tyrolia Dejuan Wilson is an Addiction (Substance Use Disorder) Counselor based in Salina, KS and is specialized in Addiction (Substance Use Disorder). Tyrolia Dejuan Wilson practices in Kansas City, KS. The NPI Number for Tyrolia Dejuan Wilson is 1588194450 and holds a License No. 949 (Kansas).

The current practice location address for Tyrolia Dejuan Wilson is 1121 N 5Th St, Kansas City, KS and can be reached out via phone at 913-831-2820 and via fax at 913-831-0262.

Location: 1121 N 5Th St, Kansas City, KS, 67401-2353
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588194450
Provider Name
Tyrolia Dejuan Wilson
Credential
Provider Entity Type
Individual
Gender
Male
Address
1121 N 5Th St, Kansas City, KS, 67401-2353
Phone Number
913-831-2820
Fax Number
913-831-0262
Provider Enumeration Date
06/14/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1121 N 5Th St
City
Kansas City
State
Kansas
Zip
66101-2305
Phone Number
913-831-2820
Fax Number
913-831-0262
person
Provider Business Mailing Address Details
Address
1121 N 5Th St
City
Kansas City
State
Kansas
Zip
66101-2305
Phone Number
913-831-2820
Fax Number
913-831-0262
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
949 (Kansas)
Definition
Definition to come...
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