Individual
ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4961 BUFORD HWY, SUITE 201, CHAMBLEE, GA 30341-3535
(404) 575-4000
Mailing address
11230 WILSHIRE CHASE DR, JOHNS CREEK, GA 30097-1755
(678) 468-4353
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008674
GA
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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