Individual
CASEY LAURA WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
1 WASHINGTON ST, TAUNTON, MA 02780-3960
(508) 828-9116
Mailing address
22 CAVAN XING, MANSFIELD, MA 02048-3440
(508) 364-1879
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
06/23/2023
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