| Doctor Name: | AIMEE M WILSON |
| NPI Number: | 1669655163 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 48833 |
| Business Practice Address: | 4061 Suzanne Dr Suite C & C Diberville, MS - 395403735 |
| Business Phone Number: | 2283964434 |
| Business Fax Number: | |
| Mailing Address: | 704 Dogwood Dr, LONG BEACH |
| State: | MS |
| Postal Code: | 395603805 |
| Phone Number: | 2288069936 |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2007 |
| NPI Last Update Date: | 01/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 48833 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |