Provider Demographics
NPI:1811923246
Name:WILKINSON, DAWN (PHD)
Entity type:Individual
Prefix:DR
First Name:DAWN
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 1:458 N BROADWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-1767
Mailing Address - Country:US
Mailing Address - Phone:615-323-0573
Mailing Address - Fax:615-323-0574
Practice Address - Street 1:458 N BROADWAY
Practice Address - Street 2:SUITE B
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-1767
Practice Address - Country:US
Practice Address - Phone:615-323-0573
Practice Address - Fax:615-323-0574
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2651103G00000X, 103TC1900X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist