Individual
DEANNA WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
1708 1ST ST S, WILLMAR, MN 56201-4228
(218) 999-7750
Mailing address
1708 1ST ST S, WILLMAR, MN 56201-4228
(218) 999-7750
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
31957
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003042656
—
MN
Enumeration date
12/06/2023
Last updated
07/14/2026
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