Provider Demographics
NPI:1700384468
Name:G.H. WILBER, PSY.D., PLLC
Entity type:Organization
Organization Name:G.H. WILBER, PSY.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:518-719-5551
Mailing Address - Street 1:5 PINE WEST PLZ STE 511
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5587
Mailing Address - Country:US
Mailing Address - Phone:518-719-5551
Mailing Address - Fax:518-536-9022
Practice Address - Street 1:5 PINE WEST PLZ STE 511
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5587
Practice Address - Country:US
Practice Address - Phone:518-719-5551
Practice Address - Fax:518-536-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty