Individual
PAIGE WILSON
Active
Individual
PAIGE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP, HSPP
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
3593
WI
103G00000X
Clinical Neuropsychologist
Primary
6301019175
MI
103T00000X
Psychologist
6286
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306131636
—
WI
Enumeration date
06/15/2011
Last updated
11/04/2024
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