Wilson, Bryan

Wilson, Bryan is an individual health care provider with primary practice located at 111 Fayette Ave , Fayetteville WV 25840-1219. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Wilson, Bryan can be contacted via phone (304) 574-1176.

Contact Information

Primary practice address
111 Fayette Ave Fayetteville WV 25840-1219
Phone: (304) 574-1176
Fax: (304) 574-4109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X N3R136200287 West Virginia

Profile Details

NPI number 1679907984
LBN Legal business name Wilson, Bryan
Credentials ED.S., NCSP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2013
Last updated Aug 23rd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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