DR. Jennifer Mary Wilson, PSYD

NPI #1114076460 in Rockford, Illinois

Provider Information

NPI Number: 1114076460
Entity Type: Individual
Name: DR. Jennifer Mary Wilson, PSYD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PSYD
Enumeration Date: Jan 9, 2007
Last Updated: Oct 8, 2015

Practice Location

Address: 5702 ELAINE DR
Address 2: SUITE A
City: Rockford
State: Illinois
ZIP Code: 61108-2458
Phone: (815) 601-3981

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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