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Individual
DR. BRANDON J WILDE
Active
Individual
DR. BRANDON J WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9471002-6004
UT
101YM0800X
Mental Health Counselor
Primary
9471022-6044
UT
101YM0800X
Mental Health Counselor
LPC-17502
AZ
101YM0800X
Mental Health Counselor
LPC3887
ID
101YP2500X
Professional Counselor
CP3313-R
NV
Other
Enumeration date
07/02/2008
Last updated
09/10/2024
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