Candice Lynn Wilson, M.S. CCC SLP
Individual provider Active NPI Speech-Language Pathologist · Griswold, CT
NPI 1326257189 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1326257189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 003725 (CT)
- Practice address
- 97 Preston Rd
Griswold, CT 06351-2516 - Phone
- (860) 376-4438
- NPI assigned
- May 21, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003725 | CT | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 003725 | CT | Yes |
Addresses
Primary practice location
97 Preston Rd
Griswold, CT 06351-2516
Mailing address
30 Nichols LN
Waterford, CT 06385-3611
Other providers in Griswold, CT
- Town of Griswold Board of Education
- Brittany Van Steeden
- Cara Vaslet
- Mildred Wessner
- Heidi Marie Willard
- Heather Yanovitch
All providers in Griswold, CT · Speech-Language Pathologist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.