Individual
MS. PATRICIA C. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-A
Contact information
Practice address
22250 PROVIDENCE DR, SUITE 301, SOUTHFIELD, MI 48075-4825
(248) 569-5985
(248) 569-3704
Mailing address
22250 PROVIDENCE DR, SUITE 301, SOUTHFIELD, MI 48075-4825
(248) 569-5985
(248) 569-3704
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000421
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1601000421
STATE LICENSE
MI
Enumeration date
10/09/2008
Last updated
10/09/2008
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