Individual
JASON DOMINIC WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, MHPP
Contact information
Practice address
201 W SECOND ST, LONOKE, AR 72086
(501) 676-5968
(501) 676-3152
Mailing address
8018 DANWOOD DR, LITTLE ROCK, AR 72204-8312
(501) 951-3348
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747P1801X
Personal Care Attendant
—
AR
Other
Enumeration date
12/01/2006
Last updated
12/20/2023
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