Individual
DR. JACK WILTSHIRE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY. D.
Contact information
Practice address
2 EUGENE L BROWN DR, NEW PALTZ, NY 12561-3946
(845) 256-8480
Mailing address
20 SUNDOWN DR, WALDEN, NY 12586-3012
(845) 567-9293
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
008762
NY
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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