Basic Information
| Provider Information | |||||||||
| NPI: | 1760843403 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILCOX | ||||||||
| FirstName: | YOLANDA | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23 CALENDAR CT | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | LA GRANGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605252365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086179336 | ||||||||
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| Practice Location | |||||||||
| Address1: | 23 CALENDAR CT | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | LA GRANGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605252365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086179336 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2016 | ||||||||
| LastUpdateDate: | 03/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 178.009651 | IL | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.