Provider Demographics
NPI:1578924809
Name:WILKINSON, JOSHUA ROBERT
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ROBERT
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1193
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-3134
Mailing Address - Country:US
Mailing Address - Phone:808-212-8841
Mailing Address - Fax:
Practice Address - Street 1:4997 E EHIKU WAY APT D
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3134
Practice Address - Country:US
Practice Address - Phone:425-577-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
HI305103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst