Joel David Wilson
Individual provider Active NPI Speech-Language Pathologist · Walnut Creek, OH
NPI 1306363296 · NPPES record last updated Aug 23, 2017
Key facts
- NPI
- 1306363296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- COND.2017480-SP (OH)
- Practice address
- 4748 Old Pump Street
Walnut Creek, OH 44687 - Phone
- (330) 852-2457
- NPI assigned
- Aug 23, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COND.2017480-SP | OH | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walnut Hills Retirement Communities Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | COND.2017480-SP | OH | Yes |
Addresses
Primary practice location
4748 Old Pump Street
Walnut Creek, OH 44687
Mailing address
104 W Lincolnway
Minerva, OH 44657-1436
Phone (919) 802-1322
Other providers in Walnut Creek, OH
- Megan Graber
- Holly Miller
- Eleanor Runyan
- Walnut Hills Retirement Communities Inc
- Walnut Hills Retirement Communties Inc.
All providers in Walnut Creek, OH · Speech-Language Pathologist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.