Individual
DR. JASON DEAN WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, MA LLP
Contact information
Practice address
3901 CHRYSLER DR STE 1A, DETROIT, MI 48201-2167
(313) 577-1396
Mailing address
400 MACK BLVD, SUITE 2 WEST, CREDENTIALING DEPT., SUITE 400-CREDENTIALING, DETROIT, MI 48201-1138
(313) 448-9006
(248) 906-0463
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401007299
MI
103TC0700X
Clinical Psychologist
6401007299
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213119549
—
MI
Enumeration date
03/14/2007
Last updated
03/25/2020
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