Individual provider · Type 1 NPI
Michael Robert Wildman, LCAS, CCS
Addiction (Substance Use Disorder) Counselor · Greensboro, NC
NPI number
1255989810
Active
Practice location
430 Battleground Ave Unit A
Greensboro, NC 27401-2104
Mailing address
1011 Pamlico Dr
Greensboro, NC 27408-8511
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1255989810
Michael Robert Wildman, LCAS, CCS's National Provider Identifier is 1255989810, issued on Aug 27, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Greensboro, NC. The record was last updated on Aug 27, 2019.