Individual
WILSON W CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, BCBA
Contact information
Practice address
1651 OLD MEADOW RD STE 600, MC LEAN, VA 22102-4389
(703) 564-1662
Mailing address
7733 INVERSHAM DR APT 164, FALLS CHURCH, VA 22042-4448
(949) 887-7576
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
VA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/16/2018
Last updated
09/24/2021
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