Diane Marie Wildman, MALPC is a
Marriage & Family Therapist based in Youngstown, Ohio. Diane Marie Wildman is licensed to practice in Ohio (license number C-0004924) and her current practice location is
611 Belmont Ave, Youngstown, Ohio. She can be reached at her office (for appointments etc.) via phone at
(330) 744-2991.
NPI number for Diane Marie Wildman is 1669599072 and her current mailing address is 18070 Cinnamon Trl, Mantua, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669599072.
Healthcare Provider's Profile
Full Name | Diane Marie Wildman |
---|
Gender | Female |
---|
Speciality | Marriage & Family Therapist |
---|
Location | 611 Belmont Ave, Youngstown, Ohio |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1669599072
- Provider Enumeration Date: 03/23/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Diane Marie Wildman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1669599072 | NPI | - | NPPES |
000000126040 | Other | OH | ANTHEM BCBS |
2164381 | Other | OH | CIGNA BEHAVIORAL |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | C-0004924 (Ohio) | Primary |
101YS0200X | Counselor - School | C-0004924 (Ohio) | Primary |
106H00000X | Marriage & Family Therapist | C-0004924 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Diane Marie Wildman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Diane Marie Wildman, MALPC 18070 Cinnamon Trl, Mantua, OH 44255-9560 Ph: (440) 543-2455 | Diane Marie Wildman, MALPC 611 Belmont Ave, Youngstown, OH 44502-1037 Ph: (330) 744-2991 |
Reviews and Comments