Individual
TERRI L WILKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
378 E 11TH ST, FOND DU LAC, WI 54935-5253
(920) 948-7583
Mailing address
378 E 11TH ST, FOND DU LAC, WI 54935-5253
(920) 948-7583
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2893-123
WI
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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