Individual
DANIELLE WILD
Active
Individual
DANIELLE WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P22053
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8347517
AETNA
—
01
—
BCBS
20Y6E
—
Enumeration date
02/21/2023
Last updated
12/18/2024
Update your record
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