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Individual

MR. TOBIAS ALLEN WILDE SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LICSW

Contact information

Practice address
4422 30TH AVE S APT 309, FARGO, ND 58104-8441
(801) 548-8535
Mailing address
4422 30TH AVE S APT 309, FARGO, ND 58104-8441
(801) 548-8535

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24970
MN
1041C0700X
Clinical Social Worker
5797
ND

Other

Enumeration date
09/20/2011
Last updated
02/19/2024
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