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General NPI Number Information
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NPI Number | 1962505156
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Entity Type | Organization
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Legal Business Name | AP WILLCOX INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 1002 HIGHLAND AVE SUITE 200
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City | SHREVEPORT
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State | LA
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Zip | 71101-4143
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Country | US
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Telephone | 318-222-6226
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Fax | 318-222-6227
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Provider Business Mailing Address
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Address Line | 1002 HIGHLAND AVE SUITE 200
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City | SHREVEPORT
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State | LA
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Zip | 71101-4143
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Country | US
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Telephone | 318-222-6226
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Fax | 318-222-6227
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER IN PRIV PRAC
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Name | MR. ARTHUR PAUL WILLCOX
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Credential | LCSW
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Telephone | 318-222-6226
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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 | 2656
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License Number State | LA
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