Individual
DEBORAH ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCCSP
Contact information
Practice address
4508 E 13TH ST, VANCOUVER, WA 98661
(360) 574-1700
Mailing address
PO BOX 2643, VANCOUVER, WA 98668
(360) 574-1700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003308
WA
Other
Enumeration date
11/20/2007
Last updated
11/20/2007
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