Provider Demographics
NPI:1508903386
Name:WILKINSON, LENORE (PHD)
Entity Type:Individual
Prefix:
First Name:LENORE
Middle Name:
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 1:4108 UPPERGATE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3833
Mailing Address - Country:US
Mailing Address - Phone:704-724-3018
Mailing Address - Fax:704-523-7752
Practice Address - Street 1:4108 UPPERGATE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3833
Practice Address - Country:US
Practice Address - Phone:704-724-3018
Practice Address - Fax:704-523-7752
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1597103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical