Individual
ROBYN ANGELA WILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
1415 CENTER ST, TACOMA, WA 98409-8210
(253) 280-9897
(253) 280-9870
Mailing address
1415 CENTER ST, TACOMA, WA 98409-8210
(253) 280-9897
(253) 280-9870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61046261
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61046261
—
WA
Enumeration date
10/22/2020
Last updated
10/22/2020
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