Individual
MS. SUSAN A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
555 AMORY ST, JAMAICA PLAIN, MA 02130-2652
(617) 383-6522
Mailing address
555 AMORY ST, JAMAICA PLAIN, MA 02130-2652
(617) 383-6522
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
S64267241
MA
Other
Enumeration date
07/04/2008
Last updated
07/04/2008
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