Individual
DIANE MARIE WILDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MALPC
Contact information
Practice address
611 BELMONT AVE, YOUNGSTOWN, OH 44502-1037
(330) 744-2991
Mailing address
18070 CINNAMON TRL, MANTUA, OH 44255-9560
(440) 543-2455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C-0004924
OH
101YS0200X
School Counselor
C-0004924
OH
106H00000X
Marriage & Family Therapist
Primary
C-0004924
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000126040
ANTHEM BCBS
OH
01
—
2164381
CIGNA BEHAVIORAL
OH
Enumeration date
03/23/2007
Last updated
09/11/2025
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