Individual
CASEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6306 N 7TH ST, PHOENIX, AZ 85014-1549
(602) 279-5801
Mailing address
6306 N 7TH ST, PHOENIX, AZ 85014-1549
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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