Individual
TRINA RENEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH LANGUAGE PATH
Contact information
Practice address
201 SE TIDE AVE, LINCOLN CITY, OR 97367-3058
(509) 868-8944
Mailing address
1271 NE HIGHWAY 99W # 124, MCMINNVILLE, OR 97128-2720
(509) 868-8944
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12754
OR
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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