Individual
MS. TRACEY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12010 LINWOOD ST, DETROIT, MI 48206-1108
(313) 867-1090
Mailing address
7177 HUNTCLIFF CT, WEST BLOOMFIELD, MI 48322-2939
(313) 502-3956
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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