Wilson, Antigone

Wilson, Antigone is an sole proprietor health care provider with primary practice located at 2505 Court Dr , Gastonia NC 28054-2140. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Agencies / Community/Behavioral Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Wilson, Antigone can be contacted via phone (704) 884-2060.

Contact Information

Primary practice address
2505 Court Dr Gastonia NC 28054-2140
Phone: (704) 884-2060
Fax: (704) 854-4860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 21258 North Carolina
Agencies / Community/Behavioral Health 251S00000X LCASA21258 North Carolina

Profile Details

NPI number 1730541368
LBN Legal business name Wilson, Antigone
Credentials LCASA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2016
Last updated Apr 5th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730541368 NPPES
North Carolina Other LCASA21258 NORTH CAROLINA SUBSTANCE ABUSE BOARD

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