Individual
ANGELA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
761 MAIN AVE, NORWALK, CT 06851-1080
(203) 229-2000
Mailing address
761 MAIN AVE, NORWALK, CT 06851-1080
(203) 229-2000
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
003267
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
003267
CT
Other
Enumeration date
05/18/2014
Last updated
12/01/2020
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