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Contact Information

ANGELLUN V WILDER, LCSW
3004 KNIGHT ST BLDG 6
SHREVEPORT, LA71105-2502
 Phone: 318-603-6874
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Military Health Care Provider

171000000X
Indicates primary specialty

NPI Profile & details for ANGELLUN V WILDER · (Female)

NPI Number 1346416096
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 05/02/2008
Last updated 05/02/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 2176
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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