Individual
MS. ANN MARIE WANLISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ITDS, BCBA
Contact information
Practice address
9376 NW 54TH ST, SUNRISE, FL 33351-7788
(954) 652-8613
Mailing address
9376 NW 54TH ST, SUNRISE, FL 33351-7788
(954) 652-8613
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46414
CO
103K00000X
Behavior Analyst
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
06/14/2010
Last updated
02/08/2023
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