Individual
JONATHAN DANIEL WILKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4300 WOODROSE RD NW, ALBUQUERQUE, NM 87114
(505) 553-6110
Mailing address
4300 WOODROSE RD NW, ALBUQUERQUE, NM 87114-5578
(505) 553-6110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-2909
NM
Other
Enumeration date
09/12/2012
Last updated
08/26/2024
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