Individual
MISS GAIL CANNON WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1419 AMELIA ST, NEW ORLEANS, LA 70115-3624
(504) 894-9980
(504) 894-9981
Mailing address
1419 AMELIA ST, NEW ORLEANS, LA 70115-3624
(504) 894-9980
(504) 894-9981
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
383
LA
Other
Enumeration date
03/04/2007
Last updated
07/08/2007
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