| Doctor Name: | MRS. MICHAELYN WILSON |
| NPI Number: | 1932396397 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.C/CCC-SLP |
| License Number: | SP9302 |
| Business Practice Address: | 120 Hanworth Ln Daniels, WV - 258329029 |
| Business Phone Number: | 3043456313 |
| Business Fax Number: | 3047637954 |
| Mailing Address: | 120 Hanworth Ln, DANIELS |
| State: | WV |
| Postal Code: | 258329029 |
| Phone Number: | 3043456313 |
| Fax Number: | 3047637954 |
| NPI Enumeration Date: | 10/01/2007 |
| NPI Last Update Date: | 10/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP9302 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| 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 |