NPI 1043029531

Brandon Antywan Wilson

Practitioner Developmentally Disabled Services Day Training Agency Lincoln, NE

Practice location

Address: 1233 Shadow Moss Ln, Lincoln, NE 68521-8600
Phone: (402) 802-1544

Registered specialties (5)

Developmentally Disabled Services Day Training Agency Primary

Agencies Taxonomy 251C00000X

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Chore Provider

Nursing Service Related Providers Taxonomy 372500000X

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Adult Companion

Nursing Service Related Providers Taxonomy 372600000X

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Day Training/Habilitation Specialist

Nursing Service Related Providers Taxonomy 373H00000X

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Child Intellectual and/or Developmental Disabilities Respite Care

Respite Care Facility Taxonomy 385HR2060X

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Registry record

NPI: 1043029531
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Dec 2024
Record last updated: 30 Dec 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.