Individual
MRS. CHRISTINE ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
5383 PRIMROSE LAKE CIR STE B, TAMPA, FL 33647-3520
(813) 279-2737
Mailing address
5030 WESLEY DR, TAMPA, FL 33647
(813) 279-2737
(813) 279-2737
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 6126
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12026483
ASHA
—
Enumeration date
06/10/2008
Last updated
07/21/2017
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