Provider Demographics
NPI:1396100632
Name:WILKINS, ANDREA (MS, LCGC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S PENN SQ STE 960
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3400
Mailing Address - Country:US
Mailing Address - Phone:215-873-2000
Mailing Address - Fax:215-351-2331
Practice Address - Street 1:1 S PENN SQ STE 960
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3400
Practice Address - Country:US
Practice Address - Phone:215-873-2000
Practice Address - Fax:215-351-2331
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECG-0000037170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS