Individual
COURTNEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 W HAWTHORN DR, ITASCA, IL 60143-2056
(224) 633-8199
Mailing address
901 W HAWTHORN DR, ITASCA, IL 60143-2056
(224) 633-8199
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31591
IL
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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