person
Mr. Jerry Wilson
Addiction (Substance Use Disorder) Counselor in Shiprock, New Mexico
NPI 1962731786

Jerry Wilson is an Addiction (Substance Use Disorder) Counselor based in Shiprock, NM and is specialized in Addiction (Substance Use Disorder). Jerry Wilson practices in Shiprock, NM. The NPI Number for Jerry Wilson is 1962731786 and holds a License No. 0122591 (New Mexico).

The current practice location address for Jerry Wilson is Hwy 491 N. Pinon St., Shiprock, NM and can be reached out via phone at 505-368-1050 and via fax at 505-368-1055.

Location: Hwy 491 N. Pinon St., Shiprock, NM, 87420-1830
person
Provider Profile Details
NPI Number
1962731786
Provider Name
Jerry Wilson
Credential
Provider Entity Type
Individual
Gender
Male
Address
Hwy 491 N. Pinon St., Shiprock, NM, 87420-1830
Phone Number
505-368-1050
Fax Number
505-368-1055
Provider Enumeration Date
12/08/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
Hwy 491 N. Pinon St.
City
State
Zip
87420-1830
Phone Number
505-368-1050
Fax Number
505-368-1055
person
Provider Business Mailing Address Details
Address
Hwy 491 N. Pinon St.
City
State
Zip
87420-1830
Phone Number
505-368-1050
Fax Number
505-368-1055
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
0122591 (New Mexico)
Definition
Definition to come...
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