Juanakeisha Wilson, RBT 16-24410

NPI #1306337522 in Riverdale, Illinois

Provider Information

NPI Number: 1306337522
Entity Type: Individual
Name: Juanakeisha Wilson, RBT 16-24410
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Credential: RBT 16-24410
Enumeration Date: May 23, 2018
Last Updated: May 23, 2018

Practice Location

Address: 14104 S WABASH AVE
City: Riverdale
State: Illinois
ZIP Code: 60827-2236
Phone: (630) 728-1991

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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