Individual
DR. WINSTON WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFC
Contact information
Practice address
134 MONTANO LN, TAOS, NM 87571-6495
(323) 691-4071
Mailing address
PO BOX 3604, TAOS, NM 87571-3604
(323) 691-4071
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
CMF0184921
NM
106H00000X
Marriage & Family Therapist
Primary
MFC 39060
CA
Other
Enumeration date
01/10/2014
Last updated
02/22/2023
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