| NPI | 1861007916 |
|---|---|
| Professional Name | AVA J WILDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 61083275) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 7651) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |