Individual
AIDAN T WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
54275 AVENIDA VELASCO, LA QUINTA, CA 92253-3661
(760) 702-5869
Mailing address
54275 AVENIDA VELASCO, LA QUINTA, CA 92253-3661
(760) 702-5869
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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