| Wild Moon Counseling | |
|
1565 W Losey St Galesburg IL 61401-2301 | |
| (312) 728-7748 | |
| Not Available |
| Full Name | Wild Moon Counseling |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1565 W Losey St, Galesburg, Illinois |
| Authorized Official Name and Position | Candace Whitman (OWNER) |
| Authorized Official Contact | 3127287748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Moon Counseling 1565 W Losey St Galesburg IL 61401-2301 Ph: (312) 728-7748 | Wild Moon Counseling 1565 W Losey St Galesburg IL 61401-2301 Ph: (312) 728-7748 |
| NPI Number | 1558928960 |
|---|---|
| Provider Enumeration Date | 05/21/2019 |
| Last Update Date | 08/08/2023 |
| Certification Date | 08/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558928960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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