Jennifer Mary Wilson in Rockford - Clinical
Jennifer Mary Wilson - NPI 1114076460
Jennifer Mary Wilson is a Clinical in Rockford, Illinois. Jennifer Mary Wilson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jennifer Mary Wilson is 1114076460. The last update date is 2015-10-08.
Jennifer Mary Wilson's current location address is 5702 Elaine Dr, Rockford, Illinois. You can contact this provider via phone number 8156013981 and fax number 8153991959. The mailing address for Jennifer Mary Wilson is 5702 Elaine Dr, Rockford, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer Mary Wilson |
|---|---|
| Address | 5702 Elaine Dr, Rockford, Illinois |
| Phone Number | 8156013981 |
| Fax Number | 8153991959 |
| Sole Proprietor | Y |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1114076460 |
|---|---|
| Provider Enumeration Date | 2007-01-09 |
| Last Updated Date | 2015-10-08 |
Provider Mailing Address Detail
| Address | 5702 Elaine Dr |
|---|---|
| City | Rockford |
| State | Illinois (IL) |
| Post Code | 611082458 |
| Phone Number | 8156013981 |
| Fax Number | 8153991959 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 71007181 |
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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 unique 10-digit identification code assigned to Jennifer Mary Wilson by the Centers for Medicare & Medicaid Services?
The Jennifer Mary Wilson has been issued the NPI (National Provider Identifier) 1114076460, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Jennifer Mary Wilson's physical address?
The Jennifer Mary Wilson is physically located at 5702 Elaine Dr, in the city of Rockford, IL, with the postal code 611082458.
What is Jennifer Mary Wilson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jennifer Mary Wilson is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
When was the Jennifer Mary Wilson's 1114076460 issued?
The Jennifer Mary Wilson's 1114076460 was issued on 2007-01-09.
When was the information regarding Jennifer Mary Wilson most recently updated?
The details pertaining to the Jennifer Mary Wilson, including its address, specialty, and other relevant information, were last refreshed on 2015-10-08.
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