Individual
HEATHER WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 KEARSARGE RD, NORTH CONWAY, NH 03860-5331
(603) 356-6616
Mailing address
PO BOX 605, CENTER CONWAY, NH 03813-0605
(603) 413-1070
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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