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General NPI Number Information
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NPI Number | 1962398107
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Entity Type | Individual
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Provider Name | EMILY WILKERSON
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Gender |
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 13101 ALLEN RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2216
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Country | US
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Telephone | 734-785-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 25549 BAKER ST
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City | TAYLOR
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State | MI
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Zip | 48180-3124
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Country | US
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Telephone | 231-330-5034
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851120040
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License Number State | MI
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