Basic Information
| Provider Information | |||||||||
| NPI: | 1063534279 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILCOX | ||||||||
| FirstName: | JOYCE | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | RN BSN LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 313 CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | PADEN CITY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261591625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043378384 | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 2ND ST | ||||||||
| Address2: | |||||||||
| City: | SAINT MARYS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261701097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046842656 | ||||||||
| FaxNumber: | 3046842658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | AP00940548 | WV | X | Behavioral Health & Social Service Providers | Social Worker | Clinical | 163W00000X | 26925 | WV | X | Nursing Service Providers | Registered Nurse |
No ID Information.