Healthcare Provider Details

I. General information

NPI: 1164342432
Provider Name (Legal Business Name): EMILIE WILKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 CUBA MILLINGTON RD
MILLINGTON TN
38053-5411
US

IV. Provider business mailing address

136 HARBOR CLUB CIR S APT 202
MEMPHIS TN
38103-0899
US

V. Phone/Fax

Practice location:
  • Phone: 901-290-8558
  • Fax:
Mailing address:
  • Phone: 918-706-2287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8766
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: