Individual
DR. SUSAN RUE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
460 QUINCY AVE, QUINCY, MA 02169-8130
(617) 774-6070
Mailing address
460 QUINCY AVE, QUINCY, MA 02169-8130
(617) 774-6070
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
7554
MA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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