| NPI | 1568912723 |
|---|---|
| Former Name | STEPHANIE NICOLE WILKES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-8476) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-5972) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2022-05-03 |