Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 51344 | TX |
NPI | 1003033804 |
---|---|
Provider Name | Jennifer Rae Wilhelm |
First Address | Austin, TX 78757-3106 |
Second Address | Austin, TX 78757-3106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 29/04/2013 |