Individual
ANGELA WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC-I
Contact information
Practice address
1705 N FM 179, LUBBOCK, TX 79416-9441
(806) 797-8003
(806) 780-8383
Mailing address
1715 26TH ST, LUBBOCK, TX 79411-1524
(806) 780-8300
(806) 780-8383
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30139
TX
Other
Enumeration date
10/23/2017
Last updated
10/30/2017
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