Individual
MARCIA WILSON
Active
Individual
MARCIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
278567
MA
2084P0800X
Psychiatry Physician
4301
TN
2084P0804X
Child & Adolescent Psychiatry Physician
278567
MA
2084P0804X
Child & Adolescent Psychiatry Physician
4301
TN
Other
Enumeration date
05/23/2016
Last updated
05/25/2021
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