Individual
DR. TYLA WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5625
(303) 617-2300
Mailing address
1831 S DUNKIRK ST, AURORA, CO 80017-3282
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYC0001630503
CO
104100000X
Social Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/14/2020
Last updated
04/06/2026
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