Individual
TANNER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
724 HARVARD DR, OWENSBORO, KY 42301-6152
(270) 240-5051
(270) 228-4136
Mailing address
724 HARVARD DR, OWENSBORO, KY 42301-6152
(270) 240-5051
(270) 228-4136
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
247960
KY
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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