Individual
DANIEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7220 W JEFFERSON AVE STE 100, LAKEWOOD, CO 80235-2015
(303) 225-7673
(866) 283-0595
Mailing address
10260 WASHINGTON ST APT 1822, THORNTON, CO 80229-2067
(304) 617-5336
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-40921
CO
106S00000X
Behavior Technician
RBT-18-50464
CO
Other
Enumeration date
05/26/2019
Last updated
02/23/2022
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