Individual
NICOLE R WILDROUDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4104 SPRINGMILL DR, KOKOMO, IN 46902-5168
(937) 554-3667
Mailing address
4104 SPRINGMILL DR, KOKOMO, IN 46902-5168
(937) 554-3667
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.162012
OH
101YP2500X
Professional Counselor
Primary
LPC-24135
AZ
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/20/2015
Last updated
02/17/2026
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