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General NPI Number Information
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NPI Number | 1972695773
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Entity Type | Individual
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Provider Name | FLORENCE MICHELLE WILBURN LPC
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 55 DONOHOE DR
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City | HUNTINGTON
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State | WV
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Zip | 25705-8887
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Country | US
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Telephone | 304-525-7851
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Fax |
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Provider Business Mailing Address
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Address Line | 99 CRACKER BARREL DR STE 100
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1650
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Country | US
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Telephone | 304-525-7851
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1329
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License Number State | WV
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