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Individual

SHANIKA J WILDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2817 N 17TH ST, MILWAUKEE, WI 53206-2132
(414) 306-3793
Mailing address
2817 N 17TH ST, MILWAUKEE, WI 53206-2132
(414) 306-3793

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
WI
253Z00000X
In Home Supportive Care Agency
WI
261QM0850X
Adult Mental Health Clinic/Center
WI
311ZA0620X
Adult Care Home Facility
WI
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
WI
347C00000X
Private Vehicle
WI
372500000X
Chore Provider
WI
374U00000X
Home Health Aide
Primary
0017839
WI
374U00000X
Home Health Aide
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
815272179
WI
Enumeration date
12/26/2019
Last updated
03/24/2026
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