Provider Demographics
NPI:1659462950
Name:WILKINSON, GINGER CORRERO (MED, CMHT)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:CORRERO
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:MED, CMHT
Other - Prefix:MRS
Other - First Name:GINGER
Other - Middle Name:CORRERO
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CMHT
Mailing Address - Street 1:2434 SOUTH EASON BLVD.
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-6942
Mailing Address - Country:US
Mailing Address - Phone:662-844-0047
Mailing Address - Fax:662-680-6416
Practice Address - Street 1:2434 SOUTH EASON BLVD.
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6942
Practice Address - Country:US
Practice Address - Phone:662-844-0047
Practice Address - Fax:662-680-6416
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health