Individual
JENNIFER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1424 E 11 MILE RD, ROYAL OAK, MI 48067-2026
(248) 548-4044
Mailing address
1424 E 11 MILE RD, ROYAL OAK, MI 48067-2026
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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