Wilson, Kelly Lynn
Wilson, Kelly Lynn is an sole proprietor health care provider with primary practice located at 6600 Van Aalst Blvd Bldg 9250 , Fort Moore GA 31905-2102. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Wilson, Kelly Lynn can be contacted via phone (706) 545-7308.Contact Information
Primary practice address
6600 Van Aalst Blvd Bldg 9250
Fort Moore GA 31905-2102
Phone: (706) 545-7308
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA13784 | Florida |
Profile Details
| NPI number | 1710290184 |
|---|---|
| LBN Legal business name | Wilson, Kelly Lynn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2010 |
| Last updated | Dec 13th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710290184 | NPPES |
| Texas | Other | 80S945 | BLUE CROSS BLUE SHIELD |
| Texas | MEDICAID | 214307501 | BLUE CROSS BLUE SHIELD |
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