Individual
SAMANTHA H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4010 DUPONT CIR STE 411, LOUISVILLE, KY 40207-4837
(502) 275-0035
(502) 275-0034
Mailing address
4010 DUPONT CIR STE 411, LOUISVILLE, KY 40207-4837
(502) 275-0035
(502) 275-0034
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-14-16139
—
Other
Enumeration date
09/14/2010
Last updated
09/10/2021
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