| NPI | 1912149345 |
|---|---|
| Former Legal Business Name | TRACEY WILKINS, LICSW, LLC |
| Entity Type | Organization |
| Authorized Contact | TRACEY WILKINS Clinical Services Director 651-222-9985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 13119) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 15043) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2015-02-19 |