Individual
MARION DIANE WILCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3042 MCKINLEY AVE, COLUMBUS, OH 43204-3653
(614) 487-7805
(419) 747-4126
Mailing address
5225 NORTON RD, GROVE CITY, OH 43123-9664
(614) 668-3277
(419) 747-4126
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-36147
CO
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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