Provider Information for 1174005078
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MARGUERITE WILCOX LCSW
Sex: Female
NPI: 1174005078
Last Updated: 2024-10-22
Certification Date: 2024-10-17
Certification Date: 2024-10-17
Details
Name | Value | ||||||||||||
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NPI | 1174005078 | ||||||||||||
Enumeration Date | 2018-09-06 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 117 WILDERNESS DR BOYCE, LA 71409-8608 United States Phone: 318-451-3541 | Fax: | ||||||||||||
Primary Practice Address | BAYNES-JONES ARMY COMMUNITY HOSPITAL 1585 THIRD ST FORT JOHNSON, LA 71459 United States Phone: 318-451-3541 | Fax: | ||||||||||||
Secondary Practice Address(es) | 117 WILDERNESS DR | ||||||||||||
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