Individual
THOMAS HENRY WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
110 JACKSON ST, WETUMPKA, AL 36092-3020
(469) 240-1580
Mailing address
110 JACKSON ST, WETUMPKA, AL 36092-3020
(469) 240-1580
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
77731
TX
Other
Enumeration date
02/07/2021
Last updated
02/07/2021
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