Individual
ANNIE GRACE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
525 W OAKLAND AVE STE 205, JOHNSON CITY, TN 37604-1673
(423) 282-1700
(423) 282-9319
Mailing address
1181 MOUNT HOLSTON RD, BLUFF CITY, TN 37618-4208
(423) 552-4988
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1634
TN
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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