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Individual

AKIVA L WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
601 S LAKE DESTINY RD STE 350, MAITLAND, FL 32751-7222
(407) 719-3388
Mailing address
1495 MARDEN RIDGE LOOP APT 202, APOPKA, FL 32703-6984
(407) 719-3388

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/30/2025
Last updated
07/30/2025
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