Keldon Oliver Wilson
Rehabilitation Psychologist
2236 Brook Dr
Kalamazoo
, Michigan 49048-2806
Keldon Oliver Wilson
Rehabilitation Psychologist
2236 Brook Dr
Kalamazoo
, Michigan 49048-2806
(517) 213-3527
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Keldon Oliver Wilson
- 1800 Ring Rd S Apt 6321
- Kalamazoo, MI
- Zip : 49008-1002
- Phone : (517) 213-3527
Second Address
- Keldon Oliver Wilson
- 2236 Brook Dr
- Kalamazoo, MI
- Zip : 49048-2806
- Phone : (269) 492-7205
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist |
National Provider Identifier
| NPI | 1407511280 |
|---|---|
| Provider Name | Keldon Oliver Wilson |
| First Address | Kalamazoo, MI 49008-1002 |
| Second Address | Kalamazoo, MI 49048-2806 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/11/2021 |
| Last Update Date | 05/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.