Individual
KATHERINE EMILY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
601 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6933
Mailing address
5223 GRESHAM AVE, SAINT LOUIS, MO 63109-3736
(314) 853-0839
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-33407
MO
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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