Individual
AMBER LOCKLEAR WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3000
Mailing address
43 CHESTNUT ST UNIT 109, NEW HAVEN, CT 06511-5731
(843) 276-2670
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
6483
CT
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
6483
CT
Other
Enumeration date
01/05/2024
Last updated
03/15/2024
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