Individual
AMY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
303 SECOND ST, SOMERSET, KY 42501-2390
(606) 677-1166
Mailing address
1113 FAWN RUN, SOMERSET, KY 42501-8440
(606) 416-6666
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
265512
KY
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/16/2019
Last updated
07/11/2024
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