Individual
JENNIFER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
400 S MOONLIGHT RD, 12J, GARDNER, KS 66030-2502
(913) 594-2738
Mailing address
400 S MOONLIGHT RD, 12J, GARDNER, KS 66030-2502
(913) 594-2738
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2809
KS
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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