MS. Lisa Wilson

NPI #1215770003 in Patchogue, New York

Provider Information

NPI Number: 1215770003
Entity Type: Individual
Name: MS. Lisa Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jun 18, 2024
Last Updated: Jun 18, 2024

Practice Location

Address: 61 DAISY ST
City: Patchogue
State: New York
ZIP Code: 11772-2705
Phone: (631) 681-7855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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