Individual
MS. VANESSA WILSON-FAVORS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP/AUD
Contact information
Practice address
6008 FOREST RD, CHEVERLY, MD 20785-3036
(301) 322-4628
Mailing address
6008 FOREST RD, CHEVERLY, MD 20785-3036
(301) 322-4628
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06559
MD
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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