Provider Demographics
NPI:1346308251
Name:WILCOX, SCOTT DAVID (MSLPC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DAVID
Last Name:WILCOX
Suffix:
Gender:M
Credentials:MSLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 ANKENY WAY
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5649
Mailing Address - Country:US
Mailing Address - Phone:307-352-6689
Mailing Address - Fax:307-352-6691
Practice Address - Street 1:2706 ANKENY WAY
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5649
Practice Address - Country:US
Practice Address - Phone:307-352-6689
Practice Address - Fax:307-352-6691
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC#394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health