Healthcare Provider Details

I. General information

NPI: 1467231340
Provider Name (Legal Business Name): BETH ANNE WILKINS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 MONROE ST BLDG B
SYLVANIA OH
43560-2263
US

IV. Provider business mailing address

21325 BRADNER RD
LUCKEY OH
43443-9729
US

V. Phone/Fax

Practice location:
  • Phone: 419-360-6378
  • Fax: 419-837-5982
Mailing address:
  • Phone: 419-360-6378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.010333
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: