Individual
EMILY MAYBELLE-WILSON DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 LAURENCE AVE STE E, JACKSON, MI 49202-2980
(517) 750-4777
(517) 782-4717
Mailing address
120 N MAPLE ST, FOWLERVILLE, MI 48836-9502
(661) 808-5083
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101005499
MI
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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