Individual
MRS. NAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
(601) 444-5036
Mailing address
56 SERENE MEADOWS DR, HATTIESBURG, MS 39402-8773
(601) 310-7676
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2393
MS
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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