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Individual

DESHAWN J WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
965 GRIZZLY CUB DR, FRANKLIN, IN 46131-1364
(317) 738-5740
Mailing address
821 VIOLA CT UNIT B, GREENWOOD, IN 46143-5725
(317) 459-2524

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-376713
IN

Other

Enumeration date
05/08/2025
Last updated
05/08/2025
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