Individual
DR. SANDRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 JACKSON ST, NEWNAN, GA 30263-1572
(770) 251-5873
Mailing address
101 RIVER BIRCH DR, CARROLLTON, GA 30116-1860
(470) 955-3190
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PSY003843
GA
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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