Individual
KIMBERLY DAWN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
1488 OLD OCILLA RD, TIFTON, GA 31794-4152
(229) 386-5200
(229) 386-1412
Mailing address
PO BOX 7508, TIFTON, GA 31793-7508
(229) 386-5200
(229) 386-1412
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP007348
GA
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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