Stephanie N Wilson
Individual provider Active NPI Behavior Analyst · Daleville, IN
NPI 1073382503 · NPPES record last updated Dec 26, 2023
Key facts
- NPI
- 1073382503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-23-70280 (IN)
- Practice address
- 9301 S Innovation Dr Ste 103
Daleville, IN 47334-9517 - Phone
- (574) 387-4313
- NPI assigned
- Dec 26, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-23-70280 | IN | Yes |
Addresses
Primary practice location
9301 S Innovation Dr Ste 103
Daleville, IN 47334-9517
Mailing address
215 Red Coach Dr
Mishawaka, IN 46545-8307
Phone (574) 387-4313
Other providers in Daleville, IN
All providers in Daleville, IN · Behavior Analyst in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.