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Individual

RICHARD WILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 756-5353
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
11/27/2019
Last updated
11/27/2019
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