Individual
HALEY BROOKE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2464 FORTUNE DR STE 195, LEXINGTON, KY 40509-4261
(859) 899-9200
Mailing address
6600 MAN O WAR BLVD APT 11208, LEXINGTON, KY 40509-8813
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
KY
Other
Enumeration date
05/26/2026
Last updated
05/26/2026
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