Individual
MS. JAYE STANSBURY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC
Contact information
Practice address
535 E PINE ST, RIVERSIDE PROFESSIONAL OFFICES, SUITE 211, MOUNT AIRY, NC 27030-3951
(336) 786-1210
(336) 786-1408
Mailing address
PO BOX 901, PILOT MOUNTAIN, NC 27041-0901
(336) 786-1210
(336) 786-1408
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1112
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7210340
—
NC
01
—
88341
BLUE CROSS BLUE SHIELD
NC
Enumeration date
08/31/2006
Last updated
07/08/2007
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