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Individual

EMILY ENGELLAND WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
105 RIVER RD, BARBOURSVILLE, WV 25504-1205
(304) 302-2467
(304) 302-0215
Mailing address
1218 9TH ST, HUNTINGTON, WV 25701-3408
(304) 697-5804
(304) 302-0215

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
752
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0071720549
BLUE CROSS/BLUE SHIELD
WV
05
9480068000
WV
Enumeration date
08/18/2006
Last updated
09/10/2010
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