Individual
AMANDA WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
18001 N 79TH AVE STE B20, GLENDALE, AZ 85308-8390
(480) 979-6200
Mailing address
18001 N 79TH AVE STE B20, GLENDALE, AZ 85308-8390
(480) 979-6200
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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