Individual
RITA LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LANNING LN, ROLLA, MO 65401-4144
(573) 368-2393
Mailing address
PO BOX 1022, ROLLA, MO 65402-1022
(573) 364-8107
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01863
MO
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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