Individual
IVAN DARNELL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2847 DUKE ST, ALEXANDRIA, VA 22314-4512
(703) 870-3880
Mailing address
2847 DUKE ST, ALEXANDRIA, VA 22314-4512
(703) 870-3880
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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