Individual
DR. LISA DIANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
21350 W 153RD ST, OLATHE, KS 66061-5413
(913) 322-2400
(913) 621-5730
Mailing address
11642 GARNETT ST, OVERLAND PARK, KS 66210-3435
(913) 370-6541
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP03197
KS
103TC2200X
Clinical Child & Adolescent Psychologist
T-LP1703
KS
Other
Enumeration date
12/26/2007
Last updated
01/18/2023
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