Individual
AUTUMN VICTORIA WILBUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
104 MALTON ROAD, NEGAUNEE, MI 49866
(906) 228-4692
Mailing address
104 MALTON RD, NEGAUNEE, MI 49866-2000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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