Doctor Name: | KAREN WILSON |
NPI Number: | 1205140779 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SP0000000910 |
Business Practice Address: | 3207 Rosemont Dr Chattanooga, TN - 374114219 |
Business Phone Number: | 4236221551 |
Business Fax Number: | |
Mailing Address: | 4201 Gann Store Rd, HIXSON |
State: | TN |
Postal Code: | 373434131 |
Phone Number: | 4238759625 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2010 |
NPI Last Update Date: | 07/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP0000000910 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |