Individual
SAMANTHA WILKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
151 SUMMIT AVE, SUMMIT, NJ 07901-2813
(908) 598-0228
Mailing address
151 SUMMIT AVE, SUMMIT, NJ 07901-2813
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00786700
NJ
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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