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Individual

MR. JAYME ROBERT WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA,CCC-SLP

Contact information

Practice address
3285 MARTIN RD, SUITE 104, COMMERCE TOWNSHIP, MI 48390-1601
(248) 669-1230
(248) 669-4745
Mailing address
3285 MARTIN RD, SUITE 104, COMMERCE TOWNSHIP, MI 48390-1601
(248) 669-1230
(248) 669-4745

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12029617
MI

Other

Enumeration date
09/09/2010
Last updated
09/09/2010
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