| Doctor Name: | COURTNEY R WILSON |
| NPI Number: | 1780968909 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 2202005998 |
| Business Practice Address: | 605 Jefferson Davis Hwy Suite 101 Fredericksburg, VA - 224018403 |
| Business Phone Number: | 5404462654 |
| Business Fax Number: | 5403713748 |
| Mailing Address: | 605 Jefferson Davis Hwy, Suite 101 FREDERICKSBURG |
| State: | VA |
| Postal Code: | 224018403 |
| Phone Number: | 5404462654 |
| Fax Number: | 5403713748 |
| NPI Enumeration Date: | 10/06/2011 |
| NPI Last Update Date: | 10/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202005998 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| 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 |