Individual
ASHLEY JO WILDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
503 E FORT WAYNE ST, WARSAW, IN 46580-3338
(574) 267-2906
Mailing address
1140 BALDWIN ST SE, GRAND RAPIDS, MI 49506-1451
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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