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Individual

DR. JORDAN WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109
(703) 330-9933
Mailing address
301 W BROAD ST, FALLS CHURCH, VA 22046-3335
(757) 784-2454

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005701
VA

Other

Enumeration date
10/01/2017
Last updated
10/01/2017
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