Individual
HOLLY W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1004 PULASKI AVE, PEARISBURG, VA 24134-1220
(540) 599-0717
Mailing address
1004 PULASKI AVE, PEARISBURG, VA 24134-1220
(540) 599-0717
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-185132
VA
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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