Individual
MRS. EARLINE F WILLCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1322 SPACE PARK DR, SUITE C105, HOUSTON, TX 77058
(281) 218-7346
(281) 286-3015
Mailing address
PO BOX 58482, HOUSTON, TX 77258-8482
(281) 218-7346
(281) 286-3015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
04780
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052CY
BLUE CROSS BLUE SHIELD
TX
01
—
S69504
MAGELLAN
TX
Enumeration date
07/07/2005
Last updated
12/19/2007
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