Individual provider · Type 1 NPI
Johnnie Lefuel Wilson Iv, LCASA
Addiction (Substance Use Disorder) Counselor · Fayetteville, NC
NPI number
1770041592
Active
Practice location
6307 Melody Ln
Fayetteville, NC 28304-5554
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | A25300 (NC) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1770041592
Johnnie Lefuel Wilson Iv, LCASA's National Provider Identifier is 1770041592, issued on Mar 11, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fayetteville, NC. The record was last updated on Mar 11, 2019.