Most Relevant Information
Provider Data
| NPI Number: | 1003685561 |
| Provider Name: | JAIDYN BRIANA WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106E00000X |
| Specialty: | Assistant Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/26/2023 |
| Last Updated: | 12/26/2023 |
Provider Practice Location
1340 N BRICKYARD RD APT 6114
COLUMBIA
SC
292238032
Practice Location Phone/Fax
| Phone: | 8643602128 |
| Fax: |
Provider Mailing Location
1340 N BRICKYARD RD APT 6114
COLUMBIA
SC
292238032
Provider Mailing Phone/Fax
| Phone: | 8643602128 |
| Fax: |