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Individual

ELISSA D WILBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1210 WOLFE ST, LITTLE ROCK, AR 72202-4618
(501) 364-5150
(501) 364-6966
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
19-31AP-PL
AR
103TC0700X
Clinical Psychologist
Primary
202163
AR

Other

Enumeration date
04/13/2018
Last updated
01/31/2022
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