Individual
MRS. AUDRA MARIE WILKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1145 POQUONNOCK RD, GROTON, CT 06340-4620
(860) 446-9960
Mailing address
8 WAMPANOAG AVE, WESTERLY, RI 02891-2033
(401) 596-1007
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
002579
CT
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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