Individual
MISS MALLORY LINAM WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
100 SILVERTON CIR, MADISON, AL 35758-7642
(256) 679-3814
Mailing address
100 SILVERTON CIR, MADISON, AL 35758-7642
(256) 679-3814
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-13-5427
AL
106E00000X
Assistant Behavior Analyst
Primary
0-13-5427
AL
Other
Enumeration date
07/19/2013
Last updated
10/05/2016
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