Wilson, David Charles

Wilson, David Charles is an individual health care provider with primary practice located at 1600 Broad Ave , Gulfport MS 39501-3603. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Wilson, David Charles can be contacted via phone (228) 863-1132.

Contact Information

Primary practice address
1600 Broad Ave Gulfport MS 39501-3603
Phone: (228) 863-1132
Fax: (228) 865-1700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X T0472A Mississippi

Profile Details

NPI number 1417380783
LBN Legal business name Wilson, David Charles
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2013
Last updated Aug 9th, 2013 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1417380783 NPPES
Mississippi MEDICAID 00018213

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