Individual
DR. MIKHILA N WILDEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
4519 CASCADE RD SE STE 12A, GRAND RAPIDS, MI 49546-8319
(616) 256-0885
Mailing address
4519 CASCADE RD SE STE 12A, GRAND RAPIDS, MI 49546-8319
(616) 256-0885
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015706
MI
103TC0700X
Clinical Psychologist
6301015125
MI
Other
Enumeration date
06/19/2012
Last updated
01/10/2022
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