Provider Demographics
NPI:1679886188
Name:WILKINSON, LINDA ZOE (LAC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ZOE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 N ALZORA WAY
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-1904
Mailing Address - Country:US
Mailing Address - Phone:623-907-5963
Mailing Address - Fax:
Practice Address - Street 1:7200 W. BELL RD.
Practice Address - Street 2:BLDG H SUITE 107 COMPLETE COUNSELING SERVICES, LLC
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308
Practice Address - Country:US
Practice Address - Phone:602-291-0945
Practice Address - Fax:623-322-7191
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-13398101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor