person
Dr. Brandon J Wilde, CMHC
Mental Health Counselor in Provo, Utah
NPI 1710140447

Brandon J Wilde is a Mental Health Counselor based in Eagle Mountain, UT and is specialized in Mental Health. Brandon J Wilde practices in Provo, UT and has the professional credentials of CMHC. The NPI Number for Brandon J Wilde is 1710140447 and holds a License No. 9471002-6004 (Utah).

The current practice location address for Brandon J Wilde is 122 E 1700 S Bldg 3, Provo, UT and can be reached out via phone at 801-900-3656.

Location: 122 E 1700 S Bldg 3, Provo, UT, 84005-7203
person
Provider Profile Details
NPI Number
1710140447
Provider Name
Brandon J Wilde
Credential
CMHC
Provider Entity Type
Individual
Gender
Male
Address
122 E 1700 S Bldg 3, Provo, UT, 84005-7203
Phone Number
801-900-3656
Fax Number
Provider Enumeration Date
07/02/2008
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
807197600 05 ID
4290476 05 UT
institution
Provider Business Practice Location Address Details
Address
122 E 1700 S Bldg 3
City
State
Zip
84606-5644
Phone Number
801-900-3656
Fax Number
person
Provider Business Mailing Address Details
Address
122 E 1700 S Bldg 3
City
State
Zip
84606-5644
Phone Number
801-900-3656
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LPC3887 (Idaho)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
9471002-6004 (Utah)
Definition
Definition to come...
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