Organization
SHIRLEY A WILSON
Active
Other names
DeSoto Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLEY ANN WILSON PHD (PSYCHOLOGIST OWNER)
(662) 349-6658
Entity
Organization
Contact information
Practice address
7160 TCHULAHOMA RD # B, STE 1, SOUTHAVEN, MS 38671-9266
(662) 349-6658
(662) 349-6856
Mailing address
7160 TCHULAHOMA RD # B, STE 1, SOUTHAVEN, MS 38671-9266
(662) 349-6658
(662) 349-6856
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
MS
103TB0200X
Cognitive & Behavioral Psychologist
—
MS
103TC2200X
Clinical Child & Adolescent Psychologist
—
MS
Other
Enumeration date
06/29/2007
Last updated
06/30/2008
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