Gerald Lee Wilson

NPI #1194360248 in Ontario, California

Provider Information

NPI Number: 1194360248
Entity Type: Individual
Name: Gerald Lee Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Nov 13, 2019
Last Updated: Nov 13, 2019

Practice Location

Address: 2940 INLAND EMPIRE BLVD
City: Ontario
State: California
ZIP Code: 91764-4898
Phone: (909) 458-1335

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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