Individual
VIRGINIA CUTHBERT WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED.
Contact information
Practice address
130 LINWOOD LN, SUMMERVILLE, SC 29483-4327
(843) 871-9697
Mailing address
130 LINWOOD LN, SUMMERVILLE, SC 29483-4327
(843) 871-9697
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1330
SC
106H00000X
Marriage & Family Therapist
Primary
1331
SC
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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