Dallas Wilson

NPI #1043072978 in Matteson, Illinois

Provider Information

NPI Number: 1043072978
Entity Type: Individual
Name: Dallas Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jan 25, 2024
Last Updated: Jan 25, 2024

Practice Location

Address: 600 HOLIDAY PLAZA DR
City: Matteson
State: Illinois
ZIP Code: 60443-2241
Phone: (773) 641-8166

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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