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MRS. CANDICE LYNN WILSON M.S. CCC SLP
>> Speech-Language Pathologist >> Speech, Language and Hearing Service ProvidersRegistrant NPI Number: 1326257189
Individual Registrant:MRS. CANDICE LYNN WILSON M.S. CCC SLP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
97 PRESTON RD GRISWOLD, CT 06351-2516 US
Tel: 860-376-4438 Fax: --
Tel: 860-376-4438 Fax: --
Contact information for business:
30 NICHOLS LN WATERFORD, CT 06385-3611 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1326257189
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 235Z00000X | Speech, Language and Hearing Service Providers Speech-Language Pathologist | CT | 003725 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
