Individual
MINDY WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
19 E MOUNTAIN STREET, FAYETTEVILLE, AR 72701
(479) 222-1671
Mailing address
22578 OAKVIEW ROAD, SILOAM SPRINGS, AR 72761
(314) 922-4558
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
149020282
IL
104100000X
Social Worker
150102171
IL
104100000X
Social Worker
Primary
9034-C
AR
1041C0700X
Clinical Social Worker
9034-C
AR
Other
Enumeration date
02/06/2017
Last updated
11/12/2020
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