Individual
DAPHNE DUFRENE WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, NCC, LPC
Contact information
Practice address
134 KATHERINE AVE, OZARK, AL 36360-1973
(334) 803-8667
(334) 803-8666
Mailing address
PO BOX 1245, DOTHAN, AL 36302-1245
(334) 712-2720
(334) 712-2727
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4189
AL
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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