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Individual

SHARON Z WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHE

Contact information

Practice address
1835 GILMORE AVE, LAKELAND, FL 33805-3017
(863) 248-3300
(863) 534-7028
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 534-7028

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH7045
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
766780900
FL
01
79213000
MAGELLAN
FL
01
Z0785
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/30/2005
Last updated
04/30/2008
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