Healthcare Provider Details

I. General information

NPI: 1730818501
Provider Name (Legal Business Name): ANNE MARIE WILHELM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 DUBLIN RD # 100
COLUMBUS OH
43215-1000
US

IV. Provider business mailing address

421 BELLFREY DR
WESTERVILLE OH
43082-6375
US

V. Phone/Fax

Practice location:
  • Phone: 614-538-0353
  • Fax:
Mailing address:
  • Phone: 614-570-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2203858
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberC.2203858
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: