Individual
MRS. JUDITH ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
301 S WASHINGTON ST, SCHOOL DIST R 4 LAMONTE, LA MONTE, MO 65337-1183
(660) 347-5439
(660) 347-5467
Mailing address
301 S WASHINGTON ST, LA MONTE, MO 65337-1183
(660) 347-5439
(660) 347-5467
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004013319
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463311225
—
MO
Enumeration date
02/23/2007
Last updated
02/19/2009
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