| NPI | 1578242236 |
|---|---|
| Former Name | BOBBIE WILSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-07-11 |