Most Relevant Information
Provider Data
| NPI Number: | 1003428863 |
| Provider Name: | EWURA-AMA O WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/21/2020 |
| Last Updated: | 08/21/2020 |
Provider Practice Location
1233 EAGLES LANDING PKWY STE A&B
STOCKBRIDGE
GA
302816399
Practice Location Phone/Fax
| Phone: | 4044803842 |
| Fax: | 6155775654 |
Provider Mailing Location
1321 MURFREESBORO PIKE STE 702
NASHVILLE
TN
372172679
Provider Mailing Phone/Fax
| Phone: | 8443597629 |
| Fax: | 6155775654 |