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Individual
MR. WILDER HEATH
Active
Individual
MR. WILDER HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
LAMFT-5546T
AZ
106H00000X
Marriage & Family Therapist
Primary
MG60467470
WA
Other
Enumeration date
05/04/2015
Last updated
10/31/2019
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