Individual
AVA L WILKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
(864) 582-0431
Mailing address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
(864) 582-0431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AD10SP
—
SC
Enumeration date
06/01/2016
Last updated
06/01/2016
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