Individual
CARSON WHILDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
627 KIMBARK ST # 1, LONGMONT, CO 80501-4910
(515) 229-7875
Mailing address
627 KIMBARK ST. #1, LONGMONT, CO 80501
(515) 229-7875
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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