Provider Demographics
NPI:1730884503
Name:WILKERSON, AKERRIA MOZELLE
Entity type:Individual
Prefix:MISS
First Name:AKERRIA
Middle Name:MOZELLE
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20254 WOODWARD ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4740
Mailing Address - Country:US
Mailing Address - Phone:313-622-5830
Mailing Address - Fax:
Practice Address - Street 1:22851 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1990
Practice Address - Country:US
Practice Address - Phone:586-265-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician