Individual
MS. JANICE MARY WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
529 16TH AVE N, ST. CLOUD, MN 56303
(320) 656-1550
Mailing address
529 16TH AVE N, ST. CLOUD, MN 56303
(320) 656-1550
(320) 253-9735
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/20/2015
Last updated
04/20/2015
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