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MISS ARIEL DIVINITY WILCOXEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S

Contact information

Practice address
10776 FREMONT ST, YUCAIPA, CA 92399-9630
(909) 797-0114
Mailing address
10776 FREMONT ST, YUCAIPA, CA, 92399, YUCAIPA, CA 92399
(909) 797-0114

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15136
CA
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
12/20/2016
Last updated
06/05/2024
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