| NPI | 1356055347 |
|---|---|
| Former Name | MELISSA GALE WILDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3018813) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2025-02-03 |