Doctor Name: | MR. WILLIAM CHARLES WILKES |
NPI Number: | 1043587645 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | 951 |
Business Practice Address: | 3407 N Dixie Hwy Oakland Park, FL - 333342839 |
Business Phone Number: | 9546477216 |
Business Fax Number: | |
Mailing Address: | 2170 Wilton Dr Apt 214, WILTON MANORS |
State: | FL |
Postal Code: | 333052180 |
Phone Number: | 9546477216 |
Fax Number: | |
NPI Enumeration Date: | 11/27/2011 |
NPI Last Update Date: | 09/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |