NPI | 1902113624 |
---|---|
Former Name | SHARLENE M WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 06274) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005524) |
Enumeration Date | 2010-09-01 |
Last Update Date | 2010-09-01 |