Individual
TIFFANY R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 S TERRACE AVE, MOUNT VERNON, NY 10550-2406
(914) 426-0067
Mailing address
16 S TERRACE AVE, MOUNT VERNON, NY 10550-2406
(914) 426-0067
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
NY
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
11/21/2018
Last updated
11/26/2018
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