Individual
CHARLEEN WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14275 MIDWAY RD STE 260, ADDISON, TX 75001-3613
(469) 665-9445
Mailing address
1255 W 15TH ST STE 320, PLANO, TX 75075-7275
(704) 729-4522
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/06/2015
Last updated
09/30/2020
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