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General NPI Number Information
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NPI Number | 1629442967
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Entity Type | Individual
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Provider Name | KATHERINE ALBICKER WILSON LPC,
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Gender | Female
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 11/24/2015
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Provider Practice Location Address
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Address Line | 8527 MAYLAND DR SUITE 103
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City | RICHMOND
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State | VA
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Zip | 23294-4753
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Country | US
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Telephone | 804-363-2583
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Fax | 804-510-0244
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Provider Business Mailing Address
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Address Line | 4402 HEIDI PLACE
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City | MIDLOTHIAN
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State | VA
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Zip | 23112
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Country | US
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Telephone | 804-363-2583
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Fax | 804-510-0244
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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 | 0701006292
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License Number State | VA
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