Organization
WILLIAMSBURG BEHAVIORAL PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARYLL PLAMER WILSON PH.D. (PSYCHOLOGIST)
(402) 489-2218
Entity
Organization
Contact information
Practice address
3801 UNION DR STE 206, LINCOLN, NE 68516-6652
(402) 489-2218
(402) 489-3666
Mailing address
3801 UNION DR STE 206, LINCOLN, NE 68516-6652
(402) 489-2218
(402) 489-3666
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
261
NE
251S00000X
Community/Behavioral Health Agency
Primary
528
NE
251S00000X
Community/Behavioral Health Agency
766
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025107300
—
NE
05
—
10025286200
—
NE
05
—
51760228826
—
NE
Enumeration date
05/22/2012
Last updated
05/22/2012
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