Individual
AMY NICOLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 S MONROE ST FL 1, TALLAHASSEE, FL 32301-1529
(850) 860-2702
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(850) 860-2702
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38357
FL
Other
Enumeration date
06/01/2017
Last updated
05/14/2020
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