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Individual

WENDY JEAN NILSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
PSYCHIATRIC CLINICAL GROUP, 300 CRITTENDEN BLVD, ROCHESTER, NY 14642-0001
(585) 275-6733
Mailing address
PSYCHIATRIC CLINICAL GROUP, 300 CRITTENDEN BLVD, ROCHESTER, NY 14642-0001
(585) 275-6733

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
P50681
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P50681
NYS LIMITED PERMIT
NY
Enumeration date
07/11/2006
Last updated
07/08/2007
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