Individual
DR. ELLEN F WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
143 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5725
(617) 354-3611
(617) 864-9136
Mailing address
143 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5725
(617) 354-3611
(617) 864-9136
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
512
MA
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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