Most Relevant Information
Provider Data
| NPI Number: | 1003011883 |
| Provider Name: | JOSHUA SETH WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/20/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
63360 NW BRITTA ST STE 1
BEND
OR
977019475
Practice Location Phone/Fax
| Phone: | 5413184845 |
| Fax: |
Provider Mailing Location
63360 NW BRITTA ST STE 1
BEND
OR
977019475
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |