Individual
JENNIFER WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CRC
Contact information
Practice address
15 HILLTOP DR, CANTON, CT 06019-2138
(860) 202-5165
Mailing address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-3871
(860) 793-3369
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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