Individual
TANYA L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1635 FOREST HILL CT, CROFTON, MD 21114-1813
(240) 994-6985
Mailing address
1635 FOREST HILL CT, CROFTON, MD 21114-1813
(240) 994-6985
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-07-3745
MD
Other
Enumeration date
04/06/2009
Last updated
04/29/2013
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