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General NPI Number Information
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NPI Number | 1104361740
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Entity Type | Individual
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Provider Name | BRENDA S. WILHELM MA, LSW, LPCC, LSC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2017
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 141 E COURT ST SUITE B
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2467
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Country | US
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Telephone | 419-575-7910
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Fax | 419-386-0981
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Provider Business Mailing Address
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Address Line | 141 E COURT ST SUITE B
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2467
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Country | US
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Telephone | 419-575-7910
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Fax | 419-386-0981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0003505
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.0009495
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License Number State | OH
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