Wilson, Jeff Randall

Wilson, Jeff Randall is an sole proprietor health care provider with primary practice located at 141 W 46Th Ave , Gary IN 46408-3905. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Pastoral. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Wilson, Jeff Randall can be contacted via phone (219) 614-0793.

Contact Information

Primary practice address
141 W 46Th Ave Gary IN 46408-3905
Phone: (219) 614-0793
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Pastoral 101YP1600X

Profile Details

NPI number 1598906935
LBN Legal business name Wilson, Jeff Randall
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 16th, 2009
Last updated Mar 16th, 2009 - about 17 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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