| NPI | 1023668522 |
|---|---|
| Former Name | KELLY MARIE WILTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146016894) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 10373) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-12-14 |