Individual provider · Type 1 NPI

Mary Teresa Willcox, CIT

Addiction (Substance Use Disorder) Counselor · Bossier City, LA

NPI number 1679084925 Active

Practice location

1525 Fullilove Dr
Bossier City, LA 71112-3346

Mailing address

2000 Fairfield Ave
Shreveport, LA 71104-2002

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X3259 (LA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1679084925

Mary Teresa Willcox, CIT's National Provider Identifier is 1679084925, issued on Oct 13, 2017. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Bossier City, LA. The record was last updated on Oct 13, 2017.