Individual
MICHAEL ROBERT WILDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS, CCS
Contact information
Practice address
430 BATTLEGROUND AVE UNIT A, GREENSBORO, NC 27401-2104
(336) 575-9951
Mailing address
1011 PAMLICO DR, GREENSBORO, NC 27408-8511
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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