Individual
DR. KATIE ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PSYCHIATRY, CHILD AND ADOLESCENT, SAINT LOUIS, MO 63110-1002
(314) 286-1700
(314) 286-1777
Mailing address
4511 FOREST PARK AVE, STE 4300, SAINT LOUIS, MO 63108-2138
(314) 286-1700
(314) 408-2756
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2011040150
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207172503
—
MO
Enumeration date
01/04/2007
Last updated
11/15/2021
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