Individual
CHARLES BRANDON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
1007 E COOLEY DR # 107, COLTON, CA 92324-3901
(909) 388-2200
Mailing address
6051 APPLECROSS DR, RIVERSIDE, CA 92507-6493
(562) 715-8105
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
08/21/2024
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