Individual
MRS. DEBORAH JAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, CCC-SLP
Contact information
Practice address
STATE RD 531, CHAMA VALLEY SCHOOLS, TIERRA AMARILLA, NM 87575
(575) 588-7297
(575) 588-7970
Mailing address
PO DRAWER 10, TIERRA AMARILLA, NM 87575
(575) 588-7297
(575) 588-7970
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4440
NM
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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