Individual
MS. NAKIA SHANTE' WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4172 EDENBROOKE CIR, LOGANVILLE, GA 30052-5193
(770) 231-5412
Mailing address
4172 EDENBROOKE CIR, LOGANVILLE, GA 30052-5193
(770) 231-5412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MSW011324
GA
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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