Individual
ANN-THERESE NICOLE WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
111 DODGE ST, BEVERLY, MA 01915-1827
(978) 921-1182
Mailing address
111 DODGE ST, BEVERLY, MA 01915-1827
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6182
MA
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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