| NPI | 1194047449 |
|---|---|
| Former Name | KATHY ANN WILCOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 4025) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 460) |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2014-06-10 |