Individual
CASSANDRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 ACADEMY ST, BAYPORT, NY 11705-1708
(631) 472-7850
Mailing address
10 HEMLOCK RD, MOUNT SINAI, NY 11766-2727
(631) 766-6909
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
032204
NY
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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