| White Wolf Ministry | |
|
7959 Vt Route 125 Bridport VT 05734-4401 | |
| (802) 758-2222 | |
| Not Available |
| Full Name | White Wolf Ministry |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7959 Vt Route 125, Bridport, Vermont |
| Authorized Official Name and Position | Ralph Fucetola (TRUSTEE) |
| Authorized Official Contact | 9733004594 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Wolf Ministry 7959 Vt Route 125 Bridport VT 05734-4401 Ph: (973) 476-3648 | White Wolf Ministry 7959 Vt Route 125 Bridport VT 05734-4401 Ph: (802) 758-2222 |
| NPI Number | 1245878958 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 12/12/2019 |
| Certification Date | 12/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245878958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |