Healthcare Provider Details

I. General information

NPI: 1235596271
Provider Name (Legal Business Name): SABRINA WILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2016
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8895 N MILITARY TRL STE 102E
WEST PALM BEACH FL
33410-6262
US

IV. Provider business mailing address

5427 MACOON WAY
WESTLAKE FL
33470-7060
US

V. Phone/Fax

Practice location:
  • Phone: 312-331-0332
  • Fax:
Mailing address:
  • Phone: 312-331-0332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: