IndividualActive
Bruce Wilks, LADAC
NPI 1376389882 · Addiction (Substance Use Disorder) Counselor · Bolivar, TN
Provider details
- NPI number
- 1376389882
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- LADAC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
793 Tennessee St
Bolivar, TN 38008-2441
Phone: (731) 228-9068
Fax: (901) 425-9773
Approximate (ZIP-level) locationGet directions
Mailing address
793 Tennessee St
Bolivar, TN 38008-2441
Registry dates
- Enumerated
- 2024-07-03
- Last updated
- 2024-07-03
- Certified
- 2024-07-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.