Individual
DEIDRA M WILBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
PO BOX 65495, LUBBOCK, TX 79464-5495
(806) 438-9891
Mailing address
PO BOX 65495, LUBBOCK, TX 79464-5495
(806) 438-9891
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
13418
TX
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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