Individual
JENNIFER RENEE WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 WILMINGTON DR STE 220, DUPONT, WA 98327-8773
(253) 507-7004
Mailing address
6355 111TH ST SW, LAKEWOOD, WA 98499-1303
(253) 327-9651
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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