Individual
KATHRYN WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2970 JUDICIAL RD STE 100, BURNSVILLE, MN 55337-7822
(952) 224-8990
Mailing address
2970 JUDICIAL RD STE 100, BURNSVILLE, MN 55337-7822
(952) 224-8990
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
03046
MN
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
02/19/2021
Last updated
10/18/2021
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