Provider Demographics
NPI:1053045328
Name:WILKERSON, CECILIA (AUD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 W 24TH ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2490
Mailing Address - Country:US
Mailing Address - Phone:713-515-9811
Mailing Address - Fax:
Practice Address - Street 1:6330 WEST LOOP S STE 300
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2936
Practice Address - Country:US
Practice Address - Phone:832-828-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81384231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist