Individual
KAITLAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 CABARRUS AVE W, CONCORD, NC 28025-5150
(704) 239-6321
Mailing address
7361 ELBENS LN SW, CONCORD, NC 28025-5066
(704) 526-7640
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306258736
—
NC
Enumeration date
05/20/2014
Last updated
03/10/2025
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