Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 2020-033 | AL |
NPI | 1043870298 |
---|---|
Provider Name | Ms. Heather E Wilson |
First Address | Mobile, AL 36693-3100 |
Second Address | Montgomery, AL 36111-2728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2019 |
Last Update Date | 08/09/2020 |