Individual
MRS. CONSTANCE ELAINE WILDEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2200 MARKET ST STE 412, GALVESTON, TX 77550-1532
(409) 765-6321
(409) 762-9151
Mailing address
2200 MARKET ST STE 412, GALVESTON, TX 77550-1532
(409) 765-6321
(409) 762-9151
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW 03248
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
871291Q
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
08/30/2006
Last updated
07/08/2007
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