| Doctor Name: | MS. MELISSA CHRISTINE WILSON |
| NPI Number: | 1952462145 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 457 |
| Business Practice Address: | 8 Calle Medico 681 Callecita Jicarilla Santa Fe, NM - 875054724 |
| Business Phone Number: | 5054248777 |
| Business Fax Number: | 5054249777 |
| Mailing Address: | Po Box 24258, SANTA FE |
| State: | NM |
| Postal Code: | 875029258 |
| Phone Number: | 5054248777 |
| Fax Number: | 5054249777 |
| NPI Enumeration Date: | 12/12/2006 |
| NPI Last Update Date: | 04/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 457 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| 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 |