Individual
MONIQUE D WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
145 EDNAM DR STE 201, CHARLOTTESVILLE, VA 22903-4625
(434) 260-1442
Mailing address
808 RAYMOND RD, CHARLOTTESVILLE, VA 22902-6013
(917) 324-2762
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
0810005578
VA
Other
Enumeration date
05/07/2022
Last updated
01/31/2023
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