Individual
BETHANY R WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6037 W US HIGHWAY 90, LAKE CITY, FL 32055-8196
(386) 752-9191
Mailing address
2264 NW 15TH AVE, GAINESVILLE, FL 32605-5219
(352) 262-6488
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW15771
FL
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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