Individual
MS. ASHLEY N WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
515 SIMPSON DR, WINONA, MS 38967-3009
(662) 508-5116
Mailing address
515 SIMPSON DR, WINONA, MS 38967-3009
(662) 508-5116
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-182914
MS
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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