Individual
STEPHANIE JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 FENWICK DR, WOODRUFF, SC 29388-8052
(724) 393-7847
Mailing address
516 FENWICK DR, WOODRUFF, SC 29388-8052
(724) 393-7847
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
003394
NY
103K00000X
Behavior Analyst
Primary
1-21-47111
—
Other
Enumeration date
05/12/2021
Last updated
03/13/2024
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