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Individual

CHRISTY R WILKIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
3314 33RD ST S, FARGO, ND 58104-5158
(701) 237-3123
Mailing address
PO BOX 5007, MINOT, ND 58702-5007
(701) 858-0115

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3871
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
19180
ND
01
26890
BLUE SHIELD OF ND
ND
01
28142
BSND
ND
01
29129
BLUE SHIELD
ND
05
74014
ND
Enumeration date
10/13/2006
Last updated
07/30/2008
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