Individual
KIMBERLY MICHELLE WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2109 FAIRBURN RD, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
(770) 693-0829
Mailing address
2109 FAIRBURN RD, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
(770) 693-0829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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