Individual
CHARLIZE A WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
149 TOWER DR, VIRGINIA BEACH, VA 23462-3555
(757) 317-0600
(757) 317-0900
Mailing address
149 TOWER DR, VIRGINIA BEACH, VA 23462-3555
(757) 317-0600
(757) 317-0900
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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