Individual
DYSHAWNA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 COMMERCE CT, POOLER, GA 31322-9445
(615) 560-6622
Mailing address
114 COTTON BLUFF CT, GUYTON, GA 31312-7540
(912) 247-0453
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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