Brooke L Wilson CCC-SLP

NPI 1255612446 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1255612446
Gender Female
Enumeration Date 09/01/2011
Last Updated 03/05/2014
Entity Type Individual
Active Over 5 years ago
Practice Location
807 CHILDRENS WAY
NEMOURS CHILDRENS CLINIC, JACKSONVILLE
JACKSONVILLE FL, 32207-8426, US
Phone (904) 697-3600
Fax (904) 697-3792
Business Location
PO BOX 191
PROVIDER ENROLLMENT DEPARTMENT
ROCKLAND DE, 19732-0191, US
Phone (407) 650-7129
Fax (302) 651-4945
Toxanomy
Taxonomy Code 235Z00000X
License State Florida
License Number SZ5331
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According to our database, Brooke L Wilson CCC-SLP NPI is 1255612446, taxonomy code is 235Z00000X and license number is SZ5331, license state is located at Florida. Brooke L Wilson CCC-SLP physically located at 807 Childrens Way, Jacksonville FL, 32207-8426. NPI Number Brooke L Wilson CCC-SLP has the Individual type.

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1255612446 NPI number is provided on an as is basis without warranty of any kind. 1255612446 is maintained by the National Plan & Provider Enumeration System. The contents of Brooke L Wilson CCC-SLP are for informational purposes only.