Individual
MS. THERESA KATHRYN WILKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3401 DALE RD, MODESTO, CA 95356-0505
(209) 527-7739
(209) 521-0776
Mailing address
236 S ELM AVE, RIPON, CA 95366-2731
(209) 599-2256
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU1884
CA
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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