Provider Demographics
NPI:1366871246
Name:WILKEN, DOROTHY (LPC)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:
Last Name:WILKEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SILVERN ST
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-1228
Mailing Address - Country:US
Mailing Address - Phone:419-734-2942
Mailing Address - Fax:419-734-4922
Practice Address - Street 1:335 BUCKEYE BLVD.
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452
Practice Address - Country:US
Practice Address - Phone:419-734-2942
Practice Address - Fax:419-734-4922
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0900460101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional