| Doctor Name: | SANDRA WILSON WILBOURNE |
| NPI Number: | 1124312913 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, LPCA |
| License Number: | A8842 |
| Business Practice Address: | 20 Court St Roxboro, NC - 275735202 |
| Business Phone Number: | 9193391585 |
| Business Fax Number: | 4343745396 |
| Mailing Address: | 2182 Wilbourne Rd, SKIPWITH |
| State: | VA |
| Postal Code: | 239682218 |
| Phone Number: | 4343745396 |
| Fax Number: | 4343745396 |
| NPI Enumeration Date: | 06/08/2011 |
| NPI Last Update Date: | 07/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | A8842 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |