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General NPI Number Information
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NPI Number | 1952291247
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Entity Type | Individual
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Provider Name | ARIELLE WILSON
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Gender |
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 210 E 64TH ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10065-7471
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Country | US
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Telephone | 313-613-9047
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Fax |
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Provider Business Mailing Address
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Address Line | 379 S 1ST ST APT 3B
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City | BROOKLYN
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State | NY
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Zip | 11211-6076
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Country | US
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Telephone | 313-613-9047
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Fax |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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