MR. Jason Edward Wilde, LPC

NPI #1689962060 in Clearfield, Utah

Provider Information

NPI Number: 1689962060
Entity Type: Individual
Name: MR. Jason Edward Wilde, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Jul 19, 2011
Last Updated: Jul 19, 2011

Practice Location

Address: 1360 E 1450 S
City: Clearfield
State: Utah
ZIP Code: 84015-1611
Phone: (801) 773-0712

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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