Individual
NAILAH L WILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT, R-DMT
Contact information
Practice address
45 E 135TH ST, NEW YORK, NY 10037-2308
(646) 780-9385
Mailing address
226 PROSPECT PARK W # 160, BROOKLYN, NY 11215-5802
(646) 667-3802
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
002846
NY
Other
Enumeration date
06/26/2020
Last updated
11/03/2023
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