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Individual

KRISTEN DANIELLE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17958 W BROWN ST, PROGRESSIVE THERAPY LLC, WADDELL, AZ 85355-4151
(623) 535-5741
Mailing address
18537 W ONYX AVE, WADDELL, AZ 85355-4446
(480) 330-7661

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP6787
AZ
235Z00000X
Speech-Language Pathologist
TSLP6787
AZ

Other

Enumeration date
07/13/2010
Last updated
04/19/2018
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