| Wild Mind Therapy Pllc | |
|
4648 Ide Rd Wilson NY 14172-9758 | |
| (716) 727-8803 | |
| Not Available |
| Full Name | Wild Mind Therapy Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4648 Ide Rd, Wilson, New York |
| Authorized Official Name and Position | Debra Wrazin (PRESIDENT) |
| Authorized Official Contact | 7167278803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Mind Therapy Pllc 4662 Ide Rd Wilson NY 14172-9758 Ph: (716) 727-8803 | Wild Mind Therapy Pllc 4648 Ide Rd Wilson NY 14172-9758 Ph: (716) 727-8803 |
| NPI Number | 1437965100 |
|---|---|
| Provider Enumeration Date | 12/09/2024 |
| Last Update Date | 12/09/2024 |
| Certification Date | 11/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437965100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Introspective Journey Psychological Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2323 Riverview Dr, Wilson, NY 14172 Phone: 716-300-6304 |