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1134641954
BENJAMIN LEE WYLDES
OTTUMWA, IA
NPI
1134641954
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Other Name
BEN WYLDES
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-07-13
Last Update Date
2017-07-13
Business Address
BENJAMIN LEE WYLDES CADC
310 W. MAIN ST
OTTUMWA, IA 52501
Phone number: 641-683-6747
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Mailing Address
BENJAMIN LEE WYLDES CADC
PO BOX 658
OTTUMWA, IA 52501
Phone number: 641-683-6747
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