Doctor Name: | SAMANTHA WILKS |
NPI Number: | 1285009191 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 41YS00786700 |
Business Practice Address: | 151 Summit Ave Summit, NJ - 079012813 |
Business Phone Number: | 9085980228 |
Business Fax Number: | |
Mailing Address: | 151 Summit Ave, SUMMIT |
State: | NJ |
Postal Code: | 079012813 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/02/2015 |
NPI Last Update Date: | 12/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 41YS00786700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |