Individual
LIANNA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
729 BOYLSTON ST FL 5, BOSTON, MA 02116-2639
(617) 800-9007
Mailing address
729 BOYLSTON ST FL 5, BOSTON, MA 02116-2639
(617) 800-9007
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11141
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/25/2017
Last updated
01/29/2021
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