Individual
CRYSTAL WILDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., LP
Contact information
Practice address
4611 PLETTNER LN, STE. 100, EVERGREEN, CO 80439-7396
(720) 443-3112
Mailing address
4611 PLETTNER LN STE 100, EVERGREEN, CO 80439-7396
(720) 443-3112
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY.0004027
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000154871
—
CO
Enumeration date
08/17/2010
Last updated
02/24/2025
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