Individual
AMY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
390 PERRINE BLVD, MANASQUAN, NJ 08736-3834
(908) 510-1311
Mailing address
390 PERRINE BLVD, MANASQUAN, NJ 08736-3834
(908) 510-1311
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00366700
NJ
Other
Enumeration date
01/01/2020
Last updated
01/01/2020
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