Individual
MR. JOHN MULLANE WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6161 W CHARLESTON BLVD, BLDG. 3A MCT, LAS VEGAS, NV 89146-1126
(702) 498-5955
(702) 486-5755
Mailing address
6161 W CHARLESTON BLVD, BLDG. 3A MCT, LAS VEGAS, NV 89146-1126
(702) 498-5955
(702) 486-5755
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01407C
NV
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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