Individual
ELISE KATHRYN WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13354
NC
235Z00000X
Speech-Language Pathologist
O1-0001358
DE
Other
Enumeration date
02/06/2014
Last updated
04/28/2021
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