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Individual

PRESLEY WANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3401 45TH ST S STE A, FARGO, ND 58104-8970
(701) 356-4384
(701) 356-4383
Mailing address
3060 FRONTIER WAY S, FARGO, ND 58104-8909
(701) 232-2340
(701) 232-2330

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46622
CO
106S00000X
Behavior Technician

Other

Enumeration date
10/21/2016
Last updated
01/13/2021
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