Individual
DR. CONNIE J. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
720 W CENTER AVE STE C, VISALIA, CA 93291-6047
(559) 733-4566
(559) 733-4566
Mailing address
720 W CENTER AVE STE C, VISALIA, CA 93291-6047
(559) 733-4566
(559) 733-4566
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 18473
CA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY 18473
CA
Other
Enumeration date
07/24/2007
Last updated
04/29/2010
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