Individual
DEANA L S WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
420 E QUAIL RUN, OAK CREEK, WI 53154-5792
(414) 303-5465
(414) 310-7496
Mailing address
PO BOX 766, OAK CREEK, WI 53154-0766
(414) 303-5465
(414) 310-7496
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4085
WI
103TC0700X
Clinical Psychologist
Primary
2920
WI
103TC0700X
Clinical Psychologist
2920-57
WI
103TH0004X
Health Psychologist
2920
WI
Other
Enumeration date
06/10/2008
Last updated
02/12/2024
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