Provider Demographics
NPI:1083929244
Name:WILKINS, STEPHANIE LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:WILKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 11TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-3482
Mailing Address - Country:US
Mailing Address - Phone:814-931-7713
Mailing Address - Fax:
Practice Address - Street 1:1216 11TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3482
Practice Address - Country:US
Practice Address - Phone:814-931-7713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional