Individual
KERRI LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(369) 070-4717
Mailing address
PO BOX 650947, VERO BEACH, FL 32965-0947
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
05/10/2022
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