Individual
PAMELA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 WESTSIDE DR, PHENIX CITY, AL 36869-6015
(334) 614-1352
Mailing address
6 WESTSIDE DR, PHENIX CITY, AL 36869-6015
(334) 614-1352
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AL
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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