Chawanna Nicole Wilson

NPI #1417552795 in Penfield, New York

Provider Information

NPI Number: 1417552795
Entity Type: Individual
Name: Chawanna Nicole Wilson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 3, 2020
Last Updated: Dec 3, 2020

Practice Location

Address: 2025 PENFIELD RD
City: Penfield
State: New York
ZIP Code: 14526-1778
Phone: (818) 241-6780

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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