Individual
MS. MICHELLE CHRISTINE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LASUDC
Contact information
Practice address
940 E SOUTH UNION AVE, MIDVALE, UT 84047-2302
(385) 235-6926
(801) 255-7284
Mailing address
940 E SOUTH UNION AVE, MIDVALE, UT 84047-2302
(385) 235-6926
(801) 255-7284
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
270969-6008
UT
1041C0700X
Clinical Social Worker
Primary
270969-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788007788032
—
UT
Enumeration date
03/08/2006
Last updated
11/07/2018
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