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General NPI Number Information
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NPI Number | 1174348163
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Entity Type | Individual
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Provider Name | ANNIKA WILSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 29699 SOUTHFIELD RD
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2038
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Country | US
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Telephone | 248-233-4344
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Fax |
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Provider Business Mailing Address
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Address Line | 18316 BEVERLY RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-4004
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Country | US
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Telephone | 989-780-0572
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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 | 6851117430
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License Number State | MI
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