Individual
JOSHUA WILDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
5732 W DURNING DR, EAGLE, ID 83616-6238
(208) 599-4245
Mailing address
5732 W DURNING DR, EAGLE, ID 83616-6238
(208) 599-4245
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10123
ID
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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