Individual
DARCY WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
722 NE 162ND AVE, HUMAN RESOURCES, PORTLAND, OR 97230-5760
(503) 255-4205
Mailing address
722 NE 162ND AVE, HUMAN RESOURCES, PORTLAND, OR 97230-5760
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4403
OR
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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