Individual
MR. SAMMY WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC/LADAC
Contact information
Practice address
706 S. BOCHARDT, MONTICELLO, AR 71655-9663
(870) 723-7867
Mailing address
153 BURNETT LN, MONTICELLO, AR 71655-9274
(870) 723-7867
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0288L
AR
101YP2500X
Professional Counselor
Primary
P1106045
AR
Other
Enumeration date
03/27/2007
Last updated
07/11/2011
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