Individual
ANGELA DENISE WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC NCC
Contact information
Practice address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(043) 329-0017
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A12117
NC
101YP2500X
Professional Counselor
Primary
A12117
NC
Other
Enumeration date
06/13/2016
Last updated
11/02/2021
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