Individual
KATHLEEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 RENAISSANCE CTR STE 2600, DETROIT, MI 48243
(855) 832-6727
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/15/2014
Last updated
08/05/2019
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