Individual
DR. CHRISTINA KIM WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY003679
GA
103TB0200X
Cognitive & Behavioral Psychologist
PSY003679
GA
103TC0700X
Clinical Psychologist
Primary
PSY003679
GA
103TF0000X
Family Psychologist
PSY003679
GA
103TP2701X
Group Psychotherapy Psychologist
PSY003679
GA
Other
Enumeration date
07/07/2008
Last updated
08/23/2023
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