Tanysha Gibbs Wilson, MA CCC-SLP L
Speech-Language Pathologist, in Florence, SC. Individual provider (NPI-1).
NPI number1720249287
StatusActive
Last updated in NPPESJun 18, 2008
Details
- NPI
- 1720249287
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Tanysha Gibbs Wilson
- Credential
- MA CCC-SLP L
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 18, 2008
- Last updated
- Jun 18, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 2797 | SC | Yes |
| 235Z00000X | Speech-Language Pathologist, | 09141511 | MD |
Practice location
314 Hutchinson AveFlorence, SC 29505
Phone 843-664-0372
Mailing address
314 Hutchinson AveFlorence, SC 29505
Phone 843-664-0372
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