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NPI Code Detail

MEDICARE: DR. ROBERT TYLER WILKINSON LPC, NCC, ACS

MEDICARE: DR. ROBERT TYLER WILKINSON LPC, NCC, ACS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor008029GA

General Provider Information

NPI Number : 1184936460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT TYLER WILKINSON LPC, NCC, ACS
Provider Business Mailing Address
First Line : 824 EAST AVE
Second Line :
City : SCOTTDALE
State : GA
Zip : 30079
Country : US
Telephone Number : 334-498-2289
Fax Number :
Provider Business Practice Location Address
First Line : 5180 ROSWELL RD SUITE 106
Second Line :
City : ATLANTA
State : GA
Zip : 30342-1717
Country : US
Telephone Number :
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2010
Last Update Date : 01/14/2020

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