Individual
CLAIRE ELIZABETH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED, BCBA
Contact information
Practice address
25 GRANT ST, EAST NORTHPORT, NY 11731-1101
(631) 806-0615
Mailing address
25 GRANT ST, EAST NORTHPORT, NY 11731-1101
(631) 806-0615
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000373
NY
251S00000X
Community/Behavioral Health Agency
000373
NY
Other
Enumeration date
12/30/2014
Last updated
07/12/2022
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