Individual
AYNSLEE CAMILLE WILMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2924 KNIGHT ST, SUITE 434, SHREVEPORT, LA 71105-2415
(318) 631-1122
Mailing address
611 E WASHINGTON ST, APT 703, SHREVEPORT, LA 71104-3700
(318) 840-4530
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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