Individual
PAMELA WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 WASHBURN RD, TALLMADGE, OH 44278-2612
(330) 630-8055
Mailing address
116 WASHBURN RD, TALLMADGE, OH 44278-2612
(330) 630-8055
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
OH
Other
Enumeration date
10/18/2020
Last updated
10/18/2020
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