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Jacqueline Michael Wilde, LMFT
Mental Health Counselor in Santa Rosa, California
NPI 1386334217

Jacqueline Michael Wilde is a Mental Health Counselor based in Santa Rosa, CA and is specialized in Mental Health. Jacqueline Michael Wilde practices in Santa Rosa, CA and has the professional credentials of LMFT. The NPI Number for Jacqueline Michael Wilde is 1386334217 and holds a License No. 46715 (California).

The current practice location address for Jacqueline Michael Wilde is 2107 Siesta Ln, Santa Rosa, CA and can be reached out via phone at 707-331-9658.

Location: 2107 Siesta Ln, Santa Rosa, CA, 95404-3238
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386334217
Provider Name
Jacqueline Michael Wilde
Credential
LMFT
Provider Entity Type
Individual
Gender
Female
Address
2107 Siesta Ln, Santa Rosa, CA, 95404-3238
Phone Number
707-331-9658
Fax Number
Provider Enumeration Date
05/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2107 Siesta Ln
City
Santa Rosa
State
California
Zip
95404-3238
Phone Number
707-331-9658
Fax Number
person
Provider Business Mailing Address Details
Address
2107 Siesta Ln
City
Santa Rosa
State
California
Zip
95404-3238
Phone Number
707-331-9658
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
46715 (California)
Definition
Definition to come...
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