Most Relevant Information
Provider Data
| NPI Number: | 1003524141 |
| Provider Name: | JESSICA WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/08/2022 |
| Last Updated: | 11/08/2022 |
Provider Practice Location
31557 SCHOOLCRAFT RD STE 200
LIVONIA
MI
481501848
Practice Location Phone/Fax
| Phone: | 8448581116 |
| Fax: |
Provider Mailing Location
1500 DOUGLAS RD STE 230
CORAL GABLES
FL
331344108
Provider Mailing Phone/Fax
| Phone: | 8448541116 |
| Fax: |