Organization
EMILY ENGELLAND WILSON, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY ENGELLAND WILSON M.A. (OWNER/PSYCHOLOGIST)
(304) 302-2467
Entity
Organization
Contact information
Practice address
2828 1ST AVE STE 203, HUNTINGTON, WV 25702-1236
(304) 522-1133
(304) 522-1134
Mailing address
2828 1ST AVE STE 203, HUNTINGTON, WV 25702-1236
(304) 522-1133
(304) 522-1134
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
752
WV
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720549
BLUE CROSS BLUE SHIELD #
WV
01
—
1068911
WORKER'S COMPENSATION #
WV
05
—
3810006848
—
WV
05
—
9480068000
—
WV
Enumeration date
05/08/2007
Last updated
11/09/2020
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