Provider Demographics
NPI:1437281953
Name:WILKINSON, REBECCA LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNNE
Last Name:WILKINSON
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 1:410 SAINT PHILIP ST STE C
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3141
Mailing Address - Country:US
Mailing Address - Phone:985-447-8098
Mailing Address - Fax:985-447-8097
Practice Address - Street 1:410 SAINT PHILIP ST STE C
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3141
Practice Address - Country:US
Practice Address - Phone:985-447-8098
Practice Address - Fax:985-447-8097
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA857103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling