Most Relevant Information
Provider Data
| NPI Number: | 1003350604 |
| Provider Name: | KORICK WILKERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/15/2016 |
| Last Updated: | 12/15/2016 |
Provider Practice Location
721 EASTLAND AVE
RUSTON
LA
712704607
Practice Location Phone/Fax
| Phone: | 5049391402 |
| Fax: |
Provider Mailing Location
721 EASTLAND AVE
RUSTON
LA
712704607
Provider Mailing Phone/Fax
| Phone: | 5049391402 |
| Fax: |