Individual
MELISSA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3767 MAIN ST, WARRENSBURG, NY 12885-1837
(518) 623-2844
(518) 623-3416
Mailing address
1 BROAD STREET PLZ, PO BOX 357, GLENS FALLS, NY 12801-4390
(518) 761-0300
(518) 745-1378
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
400639
NY
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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