Individual
AUDRANAY SHAVONE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1324 STATE ROAD 60 E, LAKE WALES, FL 33853-4322
(863) 275-1102
Mailing address
433 FISH HAWK DR, WINTER HAVEN, FL 33884-4173
(863) 326-3050
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/27/2020
Last updated
04/23/2026
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