Individual
DR. CHRISTINA SARA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
9000 COOMBS FARM RD STE 202, MORGANTOWN, WV 26508-1150
(304) 554-0504
(304) 554-0505
Mailing address
279 GIBBONS ST, MORGANTOWN, WV 26505-3557
(304) 276-0108
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
652
WV
103TC0700X
Clinical Psychologist
652
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164505000
—
WV
Enumeration date
02/09/2006
Last updated
03/10/2021
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