Provider Demographics
NPI:1528208295
Name:WILKINS, JUDITH (PH D)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 25TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-2216
Mailing Address - Country:US
Mailing Address - Phone:806-797-5452
Mailing Address - Fax:806-792-6316
Practice Address - Street 1:3309 67TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-6134
Practice Address - Country:US
Practice Address - Phone:806-797-5452
Practice Address - Fax:806-792-6316
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX922101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional