Individual
ALISA MICHELLE WILSON-COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15290 SW ROYALTY PKWY, TIGARD, OR 97224-4059
(971) 256-4050
Mailing address
15290 SW ROYALTY PKWY # 300, TIGARD, OR 97224-4059
(971) 256-4050
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7278236
OR
Other
Enumeration date
10/15/2018
Last updated
10/15/2018
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