P. DIANE WILD

BOULDER, CO
NPI1821120353
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CO  979032)
Enumeration Date2007-03-11
Last Update Date2007-07-08
Business Address
Ms. P. DIANE WILD LCSW
2315 BROADWAY ST
BOULDER, CO 80304-4122
Phone number: 303-443-3174
Mailing Address
Ms. P. DIANE WILD LCSW
2315 BROADWAY ST
BOULDER, CO 80304-4122
Phone number: 303-443-3174
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