Wilde, Deanna
Wilde, Deanna is an sole proprietor health care provider with primary practice located at 328 3Rd St Sw , Willmar MN 56201-3475. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Wilde, Deanna can be contacted via phone (320) 231-9763.Contact Information
Primary practice address
328 3Rd St Sw
Willmar MN 56201-3475
Phone: (320) 231-9763
Fax: (320) 235-0334
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 31957 | Minnesota |
Profile Details
| NPI number | 1053188425 |
|---|---|
| LBN Legal business name | Wilde, Deanna |
| Credentials | LGSW, ADC-T |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 6th, 2023 |
| Last updated | Dec 6th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053188425 | NPPES |
| Minnesota | MEDICAID | 1003042656 |
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