| Doctor Name: | SARAH MALLARD WILSON |
| NPI Number: | 1023312006 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | P78680 |
| Business Practice Address: | 20 S Broadway Suite 1109 Yonkers, NY - 107013713 |
| Business Phone Number: | 9143450700 |
| Business Fax Number: | 9142076590 |
| Mailing Address: | 580 White Plains Rd, Suite 510 TARRYTOWN |
| State: | NY |
| Postal Code: | 105915198 |
| Phone Number: | 9143455900 |
| Fax Number: | 9145923829 |
| NPI Enumeration Date: | 01/05/2011 |
| NPI Last Update Date: | 02/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | P78680 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |