Organization
A WILDER COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER NICOLE WILDER LCPC, LAC (CLINICAL PROFESSIONAL COUNSELOR)
(620) 804-2942
Entity
Organization
Contact information
Practice address
215 FIRST ST, GARFIELD, KS 67529-2976
(620) 804-2942
Mailing address
PO BOX 42, GARFIELD, KS 67529-0042
(620) 804-2942
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/17/2021
Last updated
01/17/2021
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