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General NPI Number Information
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NPI Number | 1174706931
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Entity Type | Individual
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Provider Name | HENRIETTA CARTER WILCOX LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 4410 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-6515
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Country | US
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Telephone | 586-573-1810
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Fax |
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Provider Business Mailing Address
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Address Line | 121 BEAR CREEK TRL
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City | HAMPTON
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State | GA
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Zip | 30228-2265
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Country | US
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Telephone | 470-497-9573
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801079343
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License Number State | MI
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