Provider Demographics
NPI:1194238568
Name:WILKINS, HERBERT GEORGE JR (MS)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:GEORGE
Last Name:WILKINS
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 DICKS AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19153-2415
Mailing Address - Country:US
Mailing Address - Phone:267-258-2161
Mailing Address - Fax:
Practice Address - Street 1:7214 DICKS AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19153-2415
Practice Address - Country:US
Practice Address - Phone:267-258-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health