Individual
KRISTEN ANNE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5315 E 9TH ST, INDIANAPOLIS, IN 46219-4305
(317) 459-2093
Mailing address
5315 E 9TH ST, INDIANAPOLIS, IN 46219-4305
(317) 459-2093
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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