Wilder, David
Wilder, David is an sole proprietor health care provider with primary practice located at 150 W University Blvd , Melbourne FL 32901-6982. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Wilder, David can be contacted via phone (321) 674-7516.Contact Information
Primary practice address
150 W University Blvd
Melbourne FL 32901-6982
Phone: (321) 674-7516
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 1-00-0072 | Florida |
Profile Details
| NPI number | 1760711154 |
|---|---|
| LBN Legal business name | Wilder, David |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2009 |
| Last updated | Dec 14th, 2009 - about 15 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 | 1760711154 | NPPES |
| Florida | Other | 686259496 | MEDICAID DD WAIVER |
| Florida | Other | 1-00-0072 | MEDICAID DD WAIVER |
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