Individual
DENNIS WILDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
1515 N 400 E STE 104, NORTH LOGAN, UT 84341-7595
(435) 755-6061
(435) 755-6091
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 755-6061
(435) 994-8362
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
261828-3502
UT
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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