| Wildflower Therapy Llc | |
|
57 S Main St Waterbury VT 05676-1557 | |
| (978) 831-3196 | |
| Not Available |
| Full Name | Wildflower Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 57 S Main St, Waterbury, Vermont |
| Authorized Official Name and Position | Jacqueline Shea Goodall (OWNER/CLINICIAN) |
| Authorized Official Contact | 9788313196 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildflower Therapy Llc 67 Fairground Rd Waterbury VT 05676-8903 Ph: (978) 831-3196 | Wildflower Therapy Llc 57 S Main St Waterbury VT 05676-1557 Ph: (978) 831-3196 |
| NPI Number | 1275373391 |
|---|---|
| Provider Enumeration Date | 05/28/2024 |
| Last Update Date | 06/24/2024 |
| Certification Date | 06/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275373391 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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