Individual
JENNIFER MARIE HEBRON WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISCW
Contact information
Practice address
1424 NE 155TH ST, SUITE 207, SHORELINE, WA 98155-7104
(858) 598-3713
Mailing address
1007 39TH AVE SE, PUYALLUP, WA 98374-2192
(253) 435-3100
(253) 435-3138
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60543263
WA
Other
Enumeration date
11/24/2008
Last updated
06/22/2021
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