Provider Demographics
NPI:1124180559
Name:WILKINSON, PATRICIA LYNN (LMSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNN
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-3635
Mailing Address - Country:US
Mailing Address - Phone:734-255-1310
Mailing Address - Fax:
Practice Address - Street 1:6223 N CANTON CENTER RD
Practice Address - Street 2:STE. 210
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2696
Practice Address - Country:US
Practice Address - Phone:734-737-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010157791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical