Individual
JAMES TYRONE WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 BELLE HALL PKWY UNIT 102, MOUNT PLEASANT, SC 29464-8322
(843) 225-0567
Mailing address
501 BELLE HALL PKWY UNIT 102, MOUNT PLEASANT, SC 29464-8322
(843) 225-0567
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12209
SC
1041C0700X
Clinical Social Worker
Primary
13946CP
SC
Other
Enumeration date
10/23/2017
Last updated
07/09/2021
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