Candice Wilt
Behavior Technician in Saint Paul, MN. Individual provider (NPI-1).
NPI number1164036703
StatusActive
Last updated in NPPESSep 1, 2020
Details
- NPI
- 1164036703
- Entity type
- Individual (NPI-1)
- Name
- Candice Wilt
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 1, 2020
- Certification date
- Sep 1, 2020
- Last updated
- Sep 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
690 Cleveland Ave S Ste 100Saint Paul, MN 55116-1319
Phone 651-493-8412
Mailing address
690 Cleveland Ave S Ste 100Saint Paul, MN 55116-1319
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