Healthcare Provider Details

I. General information

NPI: 1528975687
Provider Name (Legal Business Name): JESSICA WILKEY M.ED., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 WESTBROOK PLAZA DR
WINSTON SALEM NC
27103-1329
US

IV. Provider business mailing address

143 VALLEY GLEN DR
TROUTMAN NC
28166-7732
US

V. Phone/Fax

Practice location:
  • Phone: 336-310-5368
  • Fax:
Mailing address:
  • Phone: 207-890-0216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2840193
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: