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General NPI Number Information
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NPI Number | 1164124533
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Entity Type | Individual
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Provider Name | KAYLA WILKINSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 120 E 2ND AVE
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City | CORSICANA
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State | TX
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Zip | 75110-3115
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Country | US
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Telephone | 903-872-3772
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Fax |
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Provider Business Mailing Address
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Address Line | 8122 NE COUNTY ROAD 1040
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City | RICE
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State | TX
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Zip | 75155-3708
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Country | US
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Telephone | 903-641-9451
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 68782
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License Number State | TX
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