| NPI | 1881406593 |
|---|---|
| Doing Business As | WILDD |
| Entity Type | Organization |
| Authorized Contact | ERVIN ALLEN CARPENTER Executive Director 608-371-9621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |