Kenneth I Wilson is a Clinical in Woburn, Massachusetts. Kenneth I Wilson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth I Wilson is 1194785287. The last update date is 2020-12-20.
Kenneth I Wilson's current location address is 12 Alfred St Ste 200, Woburn, Massachusetts. You can contact this provider via phone number 7816460500 and fax number 7816467130. The mailing address for Kenneth I Wilson is 12 Alfred St Ste 200, Woburn, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth I Wilson |
|---|---|
| Address | 12 Alfred St Ste 200, Woburn, Massachusetts |
| Phone Number | 7816460500 |
| Fax Number | 7816467130 |
| Sole Proprietor | N |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1194785287 |
|---|---|
| Provider Enumeration Date | 2006-03-24 |
| Last Updated Date | 2020-12-20 |
Provider Mailing Address Detail
| Address | 12 Alfred St Ste 200 |
|---|---|
| City | Woburn |
| State | Massachusetts (MA) |
| Post Code | 18011915 |
| Phone Number | 7816460500 |
| Fax Number | 7816467130 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 3882 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the Kenneth I Wilson's 1194785287?
The Kenneth I Wilson's NPI (National Provider Identifier) Number is 1194785287. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Kenneth I Wilson located?
The Kenneth I Wilson is located at 12 Alfred St Ste 200, Woburn, MA 18011915.
What is Kenneth I Wilson's area of expertise and its corresponding taxonomy classification?
The Kenneth I Wilson's field of specialization is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1194785287 to Kenneth I Wilson?
The Centers for Medicare & Medicaid Services assigned the 1194785287 to Kenneth I Wilson on 2006-03-24.
As of what date were the Kenneth I Wilson's details last updated?
The information pertaining to the Kenneth I Wilson, including its address, specialty, and other details, was most recently updated on 2020-12-20.