| Wild Heron Pllc | |
|
38169 Us Highway 50 Gunnison CO 81230-8730 | |
| (917) 664-6582 | |
| Not Available |
| Full Name | Wild Heron Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 38169 Us Highway 50, Gunnison, Colorado |
| Authorized Official Name and Position | Eliza Kate Wicks-arshack (OWNER, THERAPIST) |
| Authorized Official Contact | 9176646582 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Heron Pllc 38169 Us Highway 50 Gunnison CO 81230-8730 Ph: (917) 664-6582 | Wild Heron Pllc 38169 Us Highway 50 Gunnison CO 81230-8730 Ph: (917) 664-6582 |
| NPI Number | 1104636968 |
|---|---|
| Provider Enumeration Date | 01/13/2025 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104636968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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