Individual
CAROL WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3131 AVENUE C, WHITE CITY, OR 97503-1443
(541) 864-8701
(541) 864-8799
Mailing address
3131 AVENUE C, WHITE CITY, OR 97503-1443
(541) 864-8701
(541) 864-8799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
05-11-92
OR
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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