Individual
DR. ALYSSA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., BCBA-D
Contact information
Practice address
232 BRUNS LANE, ONE SPARCENTER PLAZA, SPRINGFIELD, IL 62702
(217) 793-2206
Mailing address
4497 PERSHING AVE APT 513, SAINT LOUIS, MO 63108-2529
(775) 721-7986
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/02/2013
Last updated
10/02/2013
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