Individual
CHLOE LYN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4342 15TH AVE S STE 105, FARGO, ND 58103-1125
(701) 936-9495
Mailing address
1528 35TH AVE S, MOORHEAD, MN 56560-6972
(701) 540-7605
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
00000
ND
174400000X
Specialist
—
—
Other
Enumeration date
09/20/2018
Last updated
09/03/2024
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