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General NPI Number Information
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NPI Number | 1790128221
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Entity Type | Individual
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Provider Name | KATHERINE SIOBHAN WILKINSON MS, LMFT, LADC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 7371 W CHARLESTON BLVD 110
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City | LAS VEGAS
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State | NV
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Zip | 89117-1575
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Country | US
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Telephone | 702-483-8578
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Fax | 702-463-7026
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Provider Business Mailing Address
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Address Line | 7371 W CHARLESTON BLVD 110
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City | LAS VEGAS
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State | NV
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Zip | 89117-1575
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Country | US
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Telephone | 702-483-8578
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Fax | 702-463-7026
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 01298
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 01186
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License Number State | NV
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