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General NPI Number Information
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NPI Number | 1487199337
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Entity Type | Individual
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Provider Name | JAMILA WILKERSON
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Gender | Female
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 774 ALBANY ST
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City | BOSTON
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State | MA
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Zip | 02118-3551
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Country | US
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Telephone | 617-534-6184
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Fax | 617-419-1471
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Provider Business Mailing Address
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Address Line | 1010 MASSACHUSETTS AVE
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City | BOSTON
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State | MA
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Zip | 02118-2600
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Country | US
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Telephone | 617-534-3134
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Fax | 857-288-2315
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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 | 224583
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License Number State | MA
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