Doctor Name: | CAROLE ROBERTS-WILSON |
NPI Number: | 1083830475 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSCCC |
License Number: | SA4841 |
Business Practice Address: | 17 Summer Pl Rockledge, FL - 329553741 |
Business Phone Number: | 3216359871 |
Business Fax Number: | 3216359881 |
Mailing Address: | 17 Summer Pl, ROCKLEDGE |
State: | FL |
Postal Code: | 329553741 |
Phone Number: | 3216359871 |
Fax Number: | 3216359881 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA4841 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |