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Individual
KRISTINA WILKERSON
Active
Individual
KRISTINA WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1602498500
NV
101YP2500X
Professional Counselor
Primary
178012552
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1602498500
STATE
NV
01
—
178012552
IDFPR
IL
Enumeration date
02/10/2012
Last updated
02/23/2017
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