Individual
WENDELL WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-R
Contact information
Practice address
70 LINWOOD AVE, ORCHARD PARK, NY 14127-2308
(716) 675-9232
Mailing address
70 LINWOOD AVE, ORCHARD PARK, NY 14127-2308
(716) 675-9232
(716) 675-9217
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
R033870-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166001554
—
NY
Enumeration date
02/06/2012
Last updated
05/06/2024
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