Individual
KRISTIN WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPCC, LADC
Contact information
Practice address
2546 JOHNSON ST NE, MINNEAPOLIS, MN 55418-3941
(904) 370-3840
Mailing address
3250 STINSON BLVD, MINNEAPOLIS, MN 55418-2340
(612) 220-6437
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304735
MN
101YM0800X
Mental Health Counselor
Primary
CC02088
MN
Other
Enumeration date
01/14/2019
Last updated
10/21/2019
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