Provider Information for 1003028481
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CHRISTINE LYNN WILCOX L.C.S.W.
Sex: Female
NPI: 1003028481
Last Updated: 2007-08-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1003028481 | ||||||||
| Enumeration Date | 2007-05-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 18 CEDAR LN MANITOU SPRINGS, CO 80829-2305 United States Phone: 719-685-9074 | Fax: | ||||||||
| Primary Practice Address | 18 CEDAR LN MANITOU SPRINGS, CO 80829-2305 United States Phone: 719-685-9074 | Fax: | ||||||||
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