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Individual
MS. SHANNA LEIGH WILDER
Active
Individual
MS. SHANNA LEIGH WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-S
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
60443
TX
101YP2500X
Professional Counselor
60443
TX
Other
Enumeration date
10/02/2007
Last updated
09/28/2022
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