Individual
MS. ELLAKAYE WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ABA
Contact information
Practice address
1116 NIKKI VIEW DR, BRANDON, FL 33511-4868
(855) 832-6727
Mailing address
4575 SE DIXIE HWY, STUART, FL 34997-6826
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
017422400
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017422400
—
FL
Enumeration date
05/11/2017
Last updated
05/11/2017
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