Individual
DR. VANESSA LASHALLE WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
9315 TELEGRAPH RD, REDFORD, MI 48239-1260
(313) 450-4500
(313) 450-4512
Mailing address
2677 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2562
(313) 300-5045
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
640101048
MI
101YP2500X
Professional Counselor
6401011048
MI
Other
Enumeration date
12/14/2014
Last updated
03/03/2022
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