Individual
SHAWN DAVID WILDING SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NBCC
Contact information
Practice address
105 WIELAND DR, KATHLEEN, GA 31047-3100
(706) 577-1330
Mailing address
105 WIELAND DR, KATHLEEN, GA 31047-3100
(706) 577-1330
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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