Mariah Renee Wilson
Behavior Technician in Dearborn, MI. Individual provider (NPI-1).
NPI number1962394858
StatusActive
Last updated in NPPESJul 16, 2025
Details
- NPI
- 1962394858
- Entity type
- Individual (NPI-1)
- Name
- Mariah Renee Wilson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 16, 2025
- Certification date
- Jul 16, 2025
- Last updated
- Jul 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
19853 Outer DrDearborn, MI 48124-2066
Phone 313-406-5056
Mailing address
19853 Outer DrDearborn, MI 48124-2066
Phone 313-406-5056
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