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Organization
WILSON PSYCHOLOGICAL SERVICES INC
Active
Organization
WILSON PSYCHOLOGICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MARY WILSON PSY.D. (LICENSED CLINICAL PSYCHOLOGIST)
(815) 601-3981
Entity
Organization
Contact information
Practice address
5702 ELAINE DR, SUITE A, ROCKFORD, IL 61108-2458
(815) 601-3981
(815) 399-1959
Mailing address
240 WALWORTH ST, SHARON, WI 53585-9606
(815) 601-3981
(815) 399-1959
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007181
IL
Other
Enumeration date
04/09/2007
Last updated
10/08/2015
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