Individual
MRS. COURTNEY ANN WILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
164 W HOSPITALITY LN, SUITE 1-A, SAN BERNARDINO, CA 92408-3316
(909) 891-1880
(909) 891-1888
Mailing address
1233 E 39TH ST, SAN BERNARDINO, CA 92404-1825
(909) 528-8274
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/18/2008
Last updated
02/18/2008
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