Wilder, Roshelle Mae

Wilder, Roshelle Mae is an individual health care provider with primary practice located at 1825 Nw 167Th St Ste 102 , Miami Gardens FL 33056-4838. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wilder, Roshelle Mae can be contacted via phone (305) 624-7450.

Contact Information

Primary practice address
1825 Nw 167Th St Ste 102 Miami Gardens FL 33056-4838
Phone: (305) 624-7450
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1336664572
LBN Legal business name Wilder, Roshelle Mae
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2017
Last updated Aug 9th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336664572 NPPES
Florida MEDICAID 1609301654

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