Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6802085149 | MI |
NPI | 1003219049 |
---|---|
Provider Name | Linda Wilkinson |
First Address | Detroit, MI 48226-1661 |
Second Address | Detroit, MI 48207-4274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2014 |
Last Update Date | 06/10/2014 |