Individual
MISS CRYSTAL RAE WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2144 SUMTER ST STE B, COLUMBIA, SC 29201-2182
(803) 258-0533
Mailing address
14 PINEVIEW LN, ORANGEBURG, SC 29118-9169
(803) 878-9217
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-347719
NY
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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