Individual
DR. KEISHA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6573 KINGS BRANCH DR N, MOBILE, AL 36618-4697
(251) 406-1752
Mailing address
6573 KINGS BRANCH DR N, MOBILE, AL 36618-4697
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
46493
AL
103TS0200X
School Psychologist
0099-8484
AL
Other
Enumeration date
03/04/2020
Last updated
03/04/2020
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