Individual
HAILEY MARIAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 S JEFFERSON AVE, COOKEVILLE, TN 38501-4748
(931) 283-2919
Mailing address
3800 GAINESBORO GRADE APT B4, COOKEVILLE, TN 38501-8118
(954) 646-6793
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/25/2025
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