| Dennis W Wilson Phd Pllc | |
|
1020 Ellington Dr Milan TN 38358-3150 | |
| (731) 431-0609 | |
| Not Available |
| Full Name | Dennis W Wilson Phd Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1020 Ellington Dr, Milan, Tennessee |
| Authorized Official Name and Position | Dennis W Wilson (OWNER) |
| Authorized Official Contact | 7314310609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis W Wilson Phd Pllc 728 Blackmon Street Medina TN 38355-6829 Ph: (731) 431-0609 | Dennis W Wilson Phd Pllc 1020 Ellington Dr Milan TN 38358-3150 Ph: (731) 431-0609 |
| NPI Number | 1356533137 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 06/09/2011 |
| Medicare PECOS PAC ID | 0840389417 |
|---|---|
| Medicare Enrollment ID | O20071204000788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356533137 | NPI | - | NPPES |
| 36815542 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dennis W Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780625202 PECOS PAC ID: 0143232587 Enrollment ID: I20060718000304 |
S/s Wolfe Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5120 Telecom Dr, Milan, TN 38358 Phone: 731-686-9383 Fax: 731-686-9384 |