Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | P1693 | TN |
NPI | 1083142384 |
---|---|
Provider Name | Dr. Peter Franklin Wilson |
First Address | Nashville, TN 37218-1514 |
Second Address | Hendersonville, TN 37075-2714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2017 |
Last Update Date | 31/05/2017 |