Individual
WALLACE WILKINS
Active
Individual
WALLACE WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
1454
WA
103TB0200X
Cognitive & Behavioral Psychologist
1454
WA
103TC0700X
Clinical Psychologist
Primary
1454
WA
Other
Enumeration date
11/09/2006
Last updated
11/17/2022
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