Individual
DR. NATHANIEL ANDREW WILSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1201 W PEACHTREE ST NW STE 2300, ATLANTA, GA 30309-3453
(404) 550-9981
(404) 719-4242
Mailing address
PO BOX 7730, ATLANTA, GA 30357-0730
(404) 550-9981
(404) 475-4880
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002857
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624392123A
—
GA
Enumeration date
09/20/2006
Last updated
01/05/2021
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