Most Relevant Information
Provider Data
| NPI Number: | 1003174236 |
| Provider Name: | TOMMI ANN WILDE SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | SA8222 |
Most Important Dates
| Enumeration Date: | 04/25/2012 |
| Last Updated: | 04/25/2012 |
Provider Practice Location
2900 CHARLEVOIX DR SE
SUITE 200
GRAND RAPIDS
MI
495467085
Practice Location Phone/Fax
| Phone: | 8006848049 |
| Fax: |
Provider Mailing Location
23 PIED CT
ORLANDO
FL
328287132
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |