Wilder, Angellun Vanessa

Wilder, Angellun Vanessa is an individual health care provider with primary practice located at 3004 Knight St Bldg 6 , Shreveport LA 71105-2502. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Other Service Providers / Military Health Care Provider. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wilder, Angellun Vanessa can be contacted via phone (318) 603-6874.

Contact Information

Primary practice address
3004 Knight St Bldg 6 Shreveport LA 71105-2502
Phone: (318) 603-6874
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2176 Louisiana
Other Service Providers / Military Health Care Provider 171000000X 2176 Louisiana

Profile Details

NPI number 1346416096
LBN Legal business name Wilder, Angellun Vanessa
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2008
Last updated May 2nd, 2008 - about 16 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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