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Individual

KATRINA M WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCDP

Contact information

Practice address
900 WARREN AVE STE 401, EAST PROVIDENCE, RI 02914-1430
(401) 421-4000
Mailing address
900 WARREN AVE STE 401, EAST PROVIDENCE, RI 02914-1430
(401) 421-4000

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00481
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CDP00481
LICENSE
RI
Enumeration date
07/16/2010
Last updated
06/03/2024
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