Individual
BRANDI MICHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8282 28TH CT NE, SUITE A, LACEY, WA 98516-7162
(360) 915-6868
Mailing address
622 H ST SW, TUMWATER, WA 98512-8401
(910) 587-1290
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
WA
Other
Enumeration date
02/06/2015
Last updated
02/06/2015
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