Provider Demographics
NPI:1275346728
Name:WILCOX, DAVID BRETT
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRETT
Last Name:WILCOX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 METLAKATLA ST
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7666
Mailing Address - Country:US
Mailing Address - Phone:907-747-3636
Mailing Address - Fax:
Practice Address - Street 1:113 METLAKATLA ST
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7666
Practice Address - Country:US
Practice Address - Phone:907-747-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician