Provider Demographics
NPI:1003065616
Name:WILKINS, CASSAUNDRA JANIECE
Entity Type:Individual
Prefix:MS
First Name:CASSAUNDRA
Middle Name:JANIECE
Last Name:WILKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3861 ALABAMA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1001
Mailing Address - Country:US
Mailing Address - Phone:202-645-4488
Mailing Address - Fax:202-645-4590
Practice Address - Street 1:3861 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-1001
Practice Address - Country:US
Practice Address - Phone:202-645-4488
Practice Address - Fax:202-645-4590
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health