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General NPI Number Information
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NPI Number | 1598109845
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Entity Type | Individual
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Provider Name | SHERI ANN WILSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 102 JENNINGS MILL DR
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City | BOWIE
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State | MD
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Zip | 20721-7260
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Country | US
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Telephone | 202-549-8074
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Fax | 301-390-8262
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Provider Business Mailing Address
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Address Line | 102 JENNINGS MILL DR
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City | BOWIE
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State | MD
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Zip | 20721-7260
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Country | US
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Telephone | 202-549-8074
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Fax | 301-390-8262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1000085
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License Number State | DC
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