Doctor Name: | JOHNNIE V WILSON |
NPI Number: | 1902039845 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 197970 |
Business Practice Address: | 967 Regional Center Dr Oxford, MS - 386553551 |
Business Phone Number: | 6625137750 |
Business Fax Number: | 6622341699 |
Mailing Address: | 967 Regional Center Dr, OXFORD |
State: | MS |
Postal Code: | 386553551 |
Phone Number: | 6625137750 |
Fax Number: | 6622341699 |
NPI Enumeration Date: | 08/26/2009 |
NPI Last Update Date: | 08/26/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 197970 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MS |
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 |