Individual
TESS WIVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
113 WHITSETT ST, GREENVILLE, SC 29601-3138
(864) 520-1614
Mailing address
113 WHITSETT ST, GREENVILLE, SC 29601-3138
(864) 520-1614
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12156843
SC
Other
Enumeration date
02/12/2019
Last updated
04/22/2022
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