Individual
ANQUON JAROME WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 CAMP CREEK PKWY SW STE 100, ATLANTA, GA 30331-6247
(770) 999-9271
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-119687
GA
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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