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NPI Code Detail

MEDICARE: ASHLEY NICOLE WILKERSON PSYD

MEDICARE:   ASHLEY NICOLE WILKERSON  PSYD
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
1103TC2200XClinical Child & Adolescent Psychologist40921TX
2103T00000XPsychologist40921TX
3103TC0700XClinical Psychologist40921TX

General Provider Information

NPI Number : 1518810092
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY NICOLE WILKERSON PSYD
Provider Business Mailing Address
First Line : 104 TURTLE DOVE
Second Line :
City : KRUM
State : TX
Zip : 76249-5347
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2222 WELBORN ST
Second Line :
City : DALLAS
State : TX
Zip : 75219-3993
Country : US
Telephone Number : 214-559-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 05/27/2026

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Directions to “ ASHLEY NICOLE WILKERSON PSYD” Practice Location

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