Individual
SAMANTHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
127 FAIRMEADE DR, TERRELL, TX 75160-4513
(469) 560-8696
Mailing address
3009 S COUNTRY CLUB RD, GARLAND, TX 75043-1309
(469) 560-8696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
38683
TX
103TC0700X
Clinical Psychologist
38683
TX
Other
Enumeration date
04/05/2023
Last updated
08/10/2023
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