Doctor Name: | DR. CHRISTOPHER RAY WILSON |
NPI Number: | 1053550343 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 1537 |
Business Practice Address: | 2817 Reilly Road Mcxc-cod Credentials Womack Army Medical Center Fort Bragg, NC - 28310 |
Business Phone Number: | 9109078922 |
Business Fax Number: | |
Mailing Address: | 185 Woodgreen Ln, ABERDEEN |
State: | NC |
Postal Code: | 283154189 |
Phone Number: | 9103668728 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2009 |
NPI Last Update Date: | 02/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1537 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |