Provider Demographics
NPI:1447317284
Name:WILKINS, JAMIE S (MED, CCC-A)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:S
Last Name:WILKINS
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BAKER AVENUE EXT STE 303
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2139
Mailing Address - Country:US
Mailing Address - Phone:978-369-8780
Mailing Address - Fax:978-369-1043
Practice Address - Street 1:54 BAKER AVENUE EXT STE 303
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2139
Practice Address - Country:US
Practice Address - Phone:978-369-8780
Practice Address - Fax:978-369-1043
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA431231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist