Wilkerson, Ryan

Wilkerson, Ryan is an sole proprietor health care provider with primary practice located at 1750 Tree Blvd Ste 6 , St Augustine FL 32084-5719. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Wilkerson, Ryan can be contacted via phone (904) 206-7024.

Contact Information

Primary practice address
1750 Tree Blvd Ste 6 St Augustine FL 32084-5719
Phone: (904) 206-7024
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-19-38161 Florida

Profile Details

NPI number 1497284228
LBN Legal business name Wilkerson, Ryan
Credentials MA, BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2017
Last updated Nov 2nd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497284228 NPPES
Florida MEDICAID 020912700

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