Individual
CAROLYN WIGMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
324 ANCHOVIE CT, KISSIMMEE, FL 34759-4706
(407) 201-1590
Mailing address
324 ANCHOVIE CT, KISSIMMEE, FL 34759-4706
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
RBT-18-47176
FL
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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