Individual
YUTASHA WILKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5649 W WOOD ST, PHOENIX, AZ 85043-6324
(262) 993-1444
Mailing address
4209 N 25TH ST, MILWAUKEE, WI 53209-6615
(262) 894-6162
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/10/2021
Last updated
08/23/2023
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