Individual provider · Type 1 NPI

Conner Randy Wild, SAC

Addiction (Substance Use Disorder) Counselor · Madison, WI

NPI number 1699311670 Active

Practice location

122 E Olin Ave Ste 275
Madison, WI 53713-1475

Call (608) 228-0079 Map

Fax (608) 263-9045

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X18164-130 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1699311670

Conner Randy Wild, SAC's National Provider Identifier is 1699311670, issued on Nov 25, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Madison, WI. The record was last updated on Nov 25, 2019.