Raven Michelle Wilson

NPI #1003302431 in Oakland, California

Provider Information

NPI Number: 1003302431
Entity Type: Individual
Name: Raven Michelle Wilson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 9, 2018
Last Updated: Jul 9, 2018

Practice Location

Address: 400 29TH ST STE 204
City: Oakland
State: California
ZIP Code: 94609-3547
Phone: (510) 679-3545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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