Individual
JOSHUA DALE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2200 BERGQUIST DR, STE 1, LACKLAND A F B, TX 78236-9907
(918) 931-8254
Mailing address
2200 BERGQUIST DR, STE 1, LACKLAND A F B, TX 78236-9907
(918) 931-8254
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
11/08/2007
Last updated
05/31/2012
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