Individual provider · Type 1 NPI

Jacob R. Wilson, BA

Mental Health Counselor · Rockford, IL

NPI number 1023318276 Active

Practice location

8616 Northern Ave
Rockford, IL 61107-5309

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1023318276

Jacob R. Wilson, BA's National Provider Identifier is 1023318276, issued on Oct 21, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Rockford, IL. The record was last updated on Jul 31, 2014.