Individual
JESSICA C WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC-P
Contact information
Practice address
61 MAIN ST STE 5, GENESEO, NY 14454-1246
(585) 204-0188
Mailing address
3 MASSACHUSETTS ST, NUNDA, NY 14517-9406
(585) 808-4411
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
18-P119672-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-P119672-01
NEW YORK STATE PERMIT
NY
Enumeration date
01/02/2023
Last updated
01/02/2023
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