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NPI Code Detail

MEDICARE: DR. JANET C. WILSON PH.D., A.B.P.P.

MEDICARE:  DR. JANET C. WILSON  PH.D., A.B.P.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist081001708VA
2103TC0700XClinical Psychologist0810001708VA

General Provider Information

NPI Number : 1497846158
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANET C. WILSON PH.D., A.B.P.P.
Provider Business Mailing Address
First Line : 617 S TAYLOR ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-1448
Country : US
Telephone Number : 703-521-1127
Fax Number : 703-521-1127
Provider Business Practice Location Address
First Line : 617 S TAYLOR ST
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-1448
Country : US
Telephone Number : 703-521-1127
Fax Number : 703-521-1127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 09/11/2018

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