Most Relevant Information
Provider Data
| NPI Number: | 1003207457 |
| Provider Name: | BRANDI MICHELLE WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/06/2015 |
| Last Updated: | 02/06/2015 |
Provider Practice Location
8282 28TH CT NE
SUITE A
LACEY
WA
985167162
Practice Location Phone/Fax
| Phone: | 3609156868 |
| Fax: |
Provider Mailing Location
622 H ST SW
TUMWATER
WA
985128401
Provider Mailing Phone/Fax
| Phone: | 9105871290 |
| Fax: |