Individual
DONNA D. WILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3760 LAVISTA RD, SUITE 102, TUCKER, GA 30084-5615
(404) 284-0415
(404) 248-0422
Mailing address
3760 LAVISTA RD, SUITE 102, TUCKER, GA 30084-5615
(404) 284-0415
(404) 248-0422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003833
GA
Other
Enumeration date
02/26/2007
Last updated
07/09/2007
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