Individual
ALLISON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 MEADOWLANDS DR, WHITE BEAR LAKE, MN 55127-2339
(612) 315-1976
Mailing address
5206 RAINBOW LN, SAINT PAUL, MN 55112-4851
(612) 816-6282
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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