Individual
JESSICA WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
701 W ELM ST, WINFIELD, MO 63389-1102
(636) 668-8001
Mailing address
143 ELDERBERRY CT, SAINT CHARLES, MO 63303-7329
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2018032294
MO
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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