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General NPI Number Information
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NPI Number | 1215864202
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Entity Type | Individual
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Provider Name | MARY M WILCOX
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Gender | Female
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 4421 STUART ANDREW BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28217-1589
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Country | US
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Telephone | 980-343-6960
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Fax |
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Provider Business Mailing Address
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Address Line | 5930 MAPLE VIEW PL
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City | HARRISBURG
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State | NC
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Zip | 28075-3915
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Country | US
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Telephone | 704-858-0913
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4785
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License Number State | NC
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