Individual
SHANEL WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
Mailing address
1100 W 6TH AVE, GARY, IN 46402-1711
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IN
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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