| NPI | 1558012641 |
|---|---|
| Former Name | GERALDINE WILCOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.180132) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-03-31 |