Individual
CAROLINE K. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, MCD
Contact information
Practice address
4600 RIVER RD, MARRERO, LA 70072-1943
(504) 349-8677
Mailing address
104 CHARLESTON PARK, METAIRIE, LA 70005-3966
(337) 274-3890
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1701033
—
LA
Enumeration date
06/23/2020
Last updated
12/09/2021
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