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1366088502
BRYAN D WILDMAN
SPARKS, NV
NPI
1366088502
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Former Name
PRUDENCE C WILDMAN
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-11-22
Last Update Date
2019-11-22
Business Address
Mr. BRYAN D WILDMAN MA
1755 SULLIVAN LN
SPARKS, NV 89431-2815
Phone number: 775-499-5534
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Mailing Address
Mr. BRYAN D WILDMAN MA
1755 SULLIVAN LN
SPARKS, NV 89431-2815
Phone number: 775-499-5534
Copy
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