Provider Demographics
NPI:1386670115
Name:HOWELL, WILHELMENIA (PHD)
Entity Type:Individual
Prefix:
First Name:WILHELMENIA
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WOODROW WILSON DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2537
Mailing Address - Country:US
Mailing Address - Phone:229-244-5000
Mailing Address - Fax:229-244-0808
Practice Address - Street 1:303 WOODROW WILSON DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2537
Practice Address - Country:US
Practice Address - Phone:229-244-5000
Practice Address - Fax:229-244-0808
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA38829888AMedicaid
GAS16418Medicare UPIN
GA68BBGMHMedicare ID - Type Unspecified