Individual
TOMMI ANN WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2900 CHARLEVOIX DR SE, SUITE 200, GRAND RAPIDS, MI 49546-7085
(800) 684-8049
Mailing address
23 PIED CT, ORLANDO, FL 32828-7132
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA8222
FL
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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