Wildmon, Mark

Wildmon, Mark is an sole proprietor health care provider with primary practice located at 447 Road 1279 , Tupelo MS 38804-9653. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Wildmon, Mark can be contacted via phone (662) 523-2527.

Contact Information

Primary practice address
447 Road 1279 Tupelo MS 38804-9653
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 190077 Mississippi

Profile Details

NPI number 1922654912
LBN Legal business name Wildmon, Mark
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2019
Last updated Aug 14th, 2019 - about 7 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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