Provider Demographics
NPI:1316189665
Name:WILKINS, BETTY H
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:H
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 1:3503 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-1733
Mailing Address - Country:US
Mailing Address - Phone:252-823-8448
Mailing Address - Fax:252-641-5683
Practice Address - Street 1:3503 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-1733
Practice Address - Country:US
Practice Address - Phone:252-823-8448
Practice Address - Fax:252-641-5683
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-033-064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health