Individual
JESSICA WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 SAN REMO DR, SOUTH BURLINGTON, VT 05403-6385
(802) 488-7360
Mailing address
208 FLYNN AVE, SUITE 3J, BURLINGTON, VT 05401-5429
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151-0125989
VT
Other
Enumeration date
02/17/2017
Last updated
02/17/2017
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