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General NPI Number Information
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NPI Number | 1659248821
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Entity Type | Organization
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Legal Business Name | WILDER ACADEMY OF VIRTUAL EDUCATION
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 419 HUFF RD
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City | WILDER
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State | ID
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Zip | 83676-5003
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Country | US
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Telephone | 203-337-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 419 HUFF RD
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City | WILDER
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State | ID
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Zip | 83676-5003
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Country | US
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Telephone | 203-337-7400
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Fax |
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Authorized Official
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Title or Position | SPED DIRECTOR / VICE PRINCIPAL
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Name | AMY GRAUBERGER
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Credential | EDS,MA
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Telephone | 986-256-7220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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