Individual
MICAELA R WILDERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
5020 SW 28TH ST, TOPEKA, KS 66614-2348
(785) 289-1862
Mailing address
2015 NW WEST ST, TOPEKA, KS 66608-1955
(785) 230-6489
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11309
KS
1041C0700X
Clinical Social Worker
07311
KS
Other
Enumeration date
06/12/2019
Last updated
07/27/2026
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