Individual
MR. CHARLES PRUITT WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 S 13TH ST, LINCOLN, NE 68502
(308) 539-3282
(402) 474-4668
Mailing address
5115 F ST, OMAHA, NE 68117-2807
(308) 539-3282
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
H13346275
NE
Other
Enumeration date
06/21/2016
Last updated
05/29/2018
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