Provider Demographics
NPI:1902919020
Name:WILCOX, ALLISON HADLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:HADLEY
Last Name:WILCOX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4224
Mailing Address - Country:US
Mailing Address - Phone:512-517-0149
Mailing Address - Fax:
Practice Address - Street 1:1810 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4224
Practice Address - Country:US
Practice Address - Phone:512-517-0149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23886103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G69CMedicare UPIN