Provider Demographics
NPI:1427119239
Name:WILKINS, ALBERT T (M ED)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:T
Last Name:WILKINS
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5219 W CLEARWATER AVE
Mailing Address - Street 2:STE 10B
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1914
Mailing Address - Country:US
Mailing Address - Phone:509-547-2413
Mailing Address - Fax:509-542-8095
Practice Address - Street 1:5219 W CLEARWATER AVE
Practice Address - Street 2:STE 10B
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1914
Practice Address - Country:US
Practice Address - Phone:509-547-2413
Practice Address - Fax:509-542-8095
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00000004101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)