Individual
MS. PHYLLIS A. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1249 EAGLE WAY, VIRGINIA BEACH, VA 23456
(757) 471-2714
Mailing address
1249 EAGLE WAY, VIRGINIA BEACH, VA 23456
(757) 471-2714
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000386
VA
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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