Dr. Donald Lester Wilson Jr., PhD
Psychologist, Counseling in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1154429348
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154429348
- Entity type
- Individual (NPI-1)
- Name
- Dr. Donald Lester Wilson Jr.
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 20, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC1900X | Psychologist, Counseling | 20041034A | IN | Yes |
Practice location
2121 Lake AveVa Nihcs
Fort Wayne, IN 46805-5100
Phone 260-426-5431 · Fax 260-460-1481
Mailing address
726 West Superior StreetFort Wayne, IN 46802-1017
Phone 260-615-1173 · Fax 260-460-1481
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