Individual
JADEN ELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 1ST ST E, INDEPENDENCE, IA 50644-3155
(319) 332-0850
Mailing address
703 3RD ST, LA PORTE CITY, IA 50651-1506
(563) 513-9660
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108421
IA
Other
Enumeration date
05/04/2021
Last updated
01/25/2023
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