Individual
MRS. CHALON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
780 S GUARDSMAN WAY, SALT LAKE CITY, UT 84108-1374
(801) 541-0194
Mailing address
780 S GUARDSMAN WAY, SALT LAKE CITY, UT 84108-1374
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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