Organization
GARY N WILKERSON
Active
Organization
GARY N WILKERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY N WILKERSON LSATP (COUNSELOR)
(267) 258-3894
Entity
Organization
Contact information
Practice address
3217 COMMANDER SHEPARD BLVD, HAMPTON, VA 23666
(757) 215-8039
Mailing address
PO BOX 494, ONANCOCK, VA 23417-0494
(267) 258-3840
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0000066
DE
251S00000X
Community/Behavioral Health Agency
Primary
0718000262
VA
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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