Individual
ALYSSA KAY WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
940 ROYAL AVE UNIT 350, MEDFORD, OR 97504-6194
(541) 732-7497
(541) 732-3409
Mailing address
547 BRITTNI LN, CENTRAL POINT, OR 97502-2951
(541) 840-4274
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
L17660
OR
1041C0700X
Clinical Social Worker
Primary
L17660
OR
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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