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Individual

COLLEEN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
120 W JACKSON ST STE B&C, SHELBYVILLE, IN 46176-1295
(317) 512-2101
Mailing address
2871 N TALLEY RD, COLUMBUS, IN 47203-9169
(812) 344-3885

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-133651
IN

Other

Enumeration date
05/11/2021
Last updated
03/17/2022
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