Wildroudt, Nicole R

Wildroudt, Nicole R is an individual health care provider with primary practice located at 601 S Edwin C Moses Blvd Samaritan Behavioral Health, Inc. 1St Floor, Nw Bldg, Dayton OH 45417-3424. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Wildroudt, Nicole R can be contacted via phone (937) 734-9482.

Contact Information

Primary practice address
601 S Edwin C Moses Blvd Samaritan Behavioral Health, Inc. 1St Floor, Nw Bldg Dayton OH 45417-3424
Phone: (937) 734-9482
Fax: (937) 224-1625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LICDC.162012 Ohio

Profile Details

NPI number 1235526096
LBN Legal business name Wildroudt, Nicole R
Credentials LICDC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2015
Last updated Oct 13th, 2020 - about 4 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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