Individual
DR. ADAM DEFOREST WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10 BERESFORD CT, SAN MATEO, CA 94403-4597
(607) 379-4305
Mailing address
1201 MILTON ST, PITTSBURGH, PA 15218-1232
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY34482
CA
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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