NPI | 1407054778 |
---|---|
Former Name | JENNIFER DAWN WILKES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA OP60280565) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 044816) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 34.009622) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 34.009622) | |
2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: WA OP60280565) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP60280565) | |
Enumeration Date | 2007-07-06 |
Last Update Date | 2013-06-17 |