Individual
GILLIAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
175 W 13TH ST APT 1B, NEW YORK, NY 10011-7803
(929) 457-1452
Mailing address
175 W 13TH ST APT 1B, NEW YORK, NY 10011-7803
(929) 457-1452
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
025196
NY
390200000X
Student in an Organized Health Care Education/Training Program
P103064
NY
Other
Enumeration date
07/05/2021
Last updated
10/04/2022
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