Provider Demographics
NPI:1497229983
Name:WILCOX, MARIA (BCBA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:WILCOX
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 PILOT KNOB AVE
Mailing Address - Street 2:
Mailing Address - City:MANITOU SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80829-1641
Mailing Address - Country:US
Mailing Address - Phone:719-651-0083
Mailing Address - Fax:
Practice Address - Street 1:215 PILOT KNOB AVE
Practice Address - Street 2:
Practice Address - City:MANITOU SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80829-1641
Practice Address - Country:US
Practice Address - Phone:719-651-0083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst