Individual
MARK J WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMFT
Contact information
Practice address
525 PORTLAND AVE, MC 963, MINNEAPOLIS, MN 55415-1533
(612) 596-1223
Mailing address
525 PORTLAND AVE, MC 963, MINNEAPOLIS, MN 55415-1533
(612) 596-1223
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2333
MN
Other
Enumeration date
05/28/2013
Last updated
01/08/2026
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