Individual
TAMARA OLIVE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RCSWI
Contact information
Practice address
11105 SW 200TH ST, CUTLER BAY, FL 33157-8296
(786) 443-6542
Mailing address
26493 SW 149TH AVE, HOMESTEAD, FL 33032-5331
(305) 481-8118
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ISW18415
FL
106S00000X
Behavior Technician
RBT-21-187005
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RBT-21-187005
—
FL
Enumeration date
03/13/2022
Last updated
04/01/2025
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