Individual
MRS. CANDICE LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC SLP
Contact information
Practice address
97 PRESTON RD, GRISWOLD, CT 06351-2516
(860) 376-4438
Mailing address
30 NICHOLS LN, WATERFORD, CT 06385-3611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
003725
CT
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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