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DIANA SUE WILKERSON PHD

Clinical Neuropsychologist

Mansfield, Ohio

Provider NPI: 1457339087

Provider Information:
 DIANA SUE WILKERSON PHD
Gender: F
Sole Proprietor


Practice Location:
1730 RIPPLING BROOK DR  MANSFIELD, OH 44904 US
Tel: 419-756-1318  Fax: 419-529-9989

Business Mailing Address:
1730 RIPPLING BROOK DR  MANSFIELD, OH 44904 US
Tel: 419-756-1318  Fax: 419-529-9989

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OH5104

Other Provider Identifiers:

IssuerNumberStateType
2235263OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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