Individual
NYA WIELBON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3015 GREENRIDGE DR APT 39, HOUSTON, TX 77057-6021
(716) 279-9643
Mailing address
3015 GREENRIDGE DR APT 39, HOUSTON, TX 77057-6021
(716) 279-9643
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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