Individual
AVA WILK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10450 185TH ST W STE 100, LAKEVILLE, MN 55044-6696
(612) 509-1283
Mailing address
11253 14TH ST N, LAKE ELMO, MN 55042-9708
(651) 500-5945
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/22/2022
Last updated
05/22/2022
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