Individual
JACKLYN NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5231 ANDREWVILLE RD, GREENWOOD, DE 19950-2159
(302) 381-0058
Mailing address
5231 ANDREWVILLE RD, GREENWOOD, DE 19950-2159
(302) 381-0058
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65006
DE
103K00000X
Behavior Analyst
LBA2589
MD
106S00000X
Behavior Technician
RBT-20-143138
DE
235Z00000X
Speech-Language Pathologist
SLPA10432
AZ
Other
Enumeration date
01/19/2017
Last updated
04/19/2026
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