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General NPI Number Information
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NPI Number | 1891229712
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Entity Type | Individual
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Provider Name | CHRISTOPHER WILCOX LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 07/19/2017
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Provider Practice Location Address
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Address Line | 8807 VILLA VIEW CIR 202
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City | ORLANDO
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State | FL
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Zip | 32821-4112
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Country | US
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Telephone | 352-208-0284
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Fax |
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Provider Business Mailing Address
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Address Line | 8807 VILLA VIEW CIR 202
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City | ORLANDO
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State | FL
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Zip | 32821
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Country | US
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Telephone | 352-208-0284
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW14000
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License Number State | FL
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