Doctor Name: | EMILY WILSON |
NPI Number: | 1417352303 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | PCET002122 |
Business Practice Address: | 4116 Arkwright Rd Macon, GA - 312101707 |
Business Phone Number: | 4784770601 |
Business Fax Number: | 9739654580 |
Mailing Address: | 225 Wes Park Dr, PERRY |
State: | GA |
Postal Code: | 310694829 |
Phone Number: | 4784770601 |
Fax Number: | 9739654580 |
NPI Enumeration Date: | 11/04/2014 |
NPI Last Update Date: | 11/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | PCET002122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |