Individual
DR. MARVIN D'ANDRE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
119 S BURROWES ST, SUITE 607, STATE COLLEGE, PA 16801-3863
(814) 238-0921
(814) 238-1875
Mailing address
119 S BURROWES ST, SUITE 607, STATE COLLEGE, PA 16801-3863
(814) 238-0921
(814) 238-1875
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSO17102
PA
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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