Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHELLE ANNE WILDMAN, OTRL
Active Sole ProprietorMICHELLE ANNE WILDMAN, OTRL is a Behavioral Health, Residential healthcare provider located in FORT WALTON BEACH, Florida. NPI 1003962317 is currently active in the NPPES registry. Verify at CMS.
Behavioral Health, Residential · FORT WALTON BEACH, FL
Registration Details
- NPI Number
- 1003962317
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 27, 2007 (19.539334208215 yrs)
- Last Updated
- Jul 8, 2007
- License
-
11903 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
122 EGLIN PKWY NEFORT WALTON BEACH, FL, 325484917Browse FL providers · Browse ZIP 32548
- Phone
- 8505436227
- Fax
- 8508639974
- Primary Specialty
-
Behavioral Health, Residential
251C00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.