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NPI Code Detail

MEDICARE: MS. VICTORIA GARTEN WILCOX LMHC

MEDICARE: MS. VICTORIA GARTEN WILCOX LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH9378FL

General Provider Information

NPI Number : 1205139565
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VICTORIA GARTEN WILCOX LMHC
Provider Business Mailing Address
First Line : 611 E ADAMS ST
Second Line : SULZBACHER CENTER
City : JACKSONVILLE
State : FL
Zip : 32202-2847
Country : US
Telephone Number : 904-394-8098
Fax Number :
Provider Business Practice Location Address
First Line : 611 E ADAMS ST
Second Line : SULZBACHER CENTER
City : JACKSONVILLE
State : FL
Zip : 32202-2847
Country : US
Telephone Number : 904-394-8098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2010
Last Update Date : 12/08/2010

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