person
Dr. Brandon J Wilde, CMHC
Mental Health Counselor in Chubbuck, Idaho
NPI 1710140447

Brandon J Wilde is a Mental Health Counselor based in Sandy, ID and is specialized in Mental Health. Brandon J Wilde practices in Chubbuck, ID and has the professional credentials of CMHC. The NPI Number for Brandon J Wilde is 1710140447 and holds a License No. 9471002-6004 (Idaho).

The current practice location address for Brandon J Wilde is 4460 Central Way, Chubbuck, ID and can be reached out via phone at 208-237-1711 and via fax at 208-237-5192. You can also correspond with Brandon J Wilde through the mailing address at 11086 S GRAPE ARBOR PL, SANDY, UT - 84070-6708 (mailing address contact number: 719-588-6976).

Location: 4460 Central Way, Chubbuck, ID, 84070-6708
person
Provider Profile Details
NPI Number
1710140447
Provider Name
Brandon J Wilde
Credential
CMHC
Provider Entity Type
Individual
Gender
Male
Address
4460 Central Way, Chubbuck, ID, 84070-6708
Phone Number
208-237-1711
Fax Number
208-237-5192
Provider Enumeration Date
07/02/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
807197600 05 ID
institution
Provider Business Practice Location Address Details
Address
4460 Central Way
City
State
Zip
83202
Phone Number
208-237-1711
Fax Number
208-237-5192
person
Provider Business Mailing Address Details
Address
4460 Central Way
City
State
Zip
83202
Phone Number
208-237-1711
Fax Number
208-237-5192
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
9471002-6004 (Utah)
Definition
Definition to come...
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