Provider Demographics
NPI:1952829087
Name:WILCOX, CONTRINA (MA)
Entity Type:Individual
Prefix:MRS
First Name:CONTRINA
Middle Name:
Last Name:WILCOX
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 LUKE CV
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-2387
Mailing Address - Country:US
Mailing Address - Phone:404-933-1894
Mailing Address - Fax:
Practice Address - Street 1:156 LUKE CV
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-2387
Practice Address - Country:US
Practice Address - Phone:404-933-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty