Doctor Name: | ELLYN K WILHELM |
NPI Number: | 1063764918 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC-5066 |
Business Practice Address: | 7905 N Meadowlark Way Suite A&b Coeur D Alene, ID - 838155041 |
Business Phone Number: | 2087723116 |
Business Fax Number: | 2087727677 |
Mailing Address: | 7905 N Meadowlark Way, Suite A&b COEUR D ALENE |
State: | ID |
Postal Code: | 838155041 |
Phone Number: | 2087723116 |
Fax Number: | 2087727677 |
NPI Enumeration Date: | 10/02/2012 |
NPI Last Update Date: | 10/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC-5066 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |