Individual
MRS. ELIZABETH ANN WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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