Individual
JENNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
477 PROMINENCE CT STE 100, DAWSONVILLE, GA 30534-6377
(401) 216-9564
Mailing address
629 STANDING ROCK RD, SENOIA, GA 30276-1405
(404) 925-6777
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP010194
GA
Other
Enumeration date
05/20/2019
Last updated
02/27/2024
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