Individual
BENNETT A WILSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3936 CIRCLE DR, HOLMEN, WI 54636-9187
(608) 413-4825
Mailing address
W5512 COUNTY ROAD OS, ONALASKA, WI 54650-8716
(608) 790-0136
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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