| NPI | 1780187831 |
|---|---|
| Former Name | STEPHANIE LYNN WILCOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2022-12-01 |