Individual
DR. SHIRLEY ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7165 B SWINNEA, STE 1, SOUTHAVEN, MS 38671
(662) 349-6658
(662) 349-6856
Mailing address
7165 B SWINNEA, STE 1, SOUTHAVEN, MS 38671
(662) 349-6658
(662) 349-6856
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
MS
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
MS
103TC2200X
Clinical Child & Adolescent Psychologist
—
MS
Other
Enumeration date
01/30/2007
Last updated
09/11/2025
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