| Willow Tree Healing Center Llc | |
|
1516 Newmoore Dr Gloucester VA 23061 | |
| (252) 619-0887 | |
| Not Available |
| Full Name | Willow Tree Healing Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1516 Newmoore Dr, Gloucester, Virginia |
| Authorized Official Name and Position | Mary Willoughby Prentiss (OWNER) |
| Authorized Official Contact | 2526190887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Tree Healing Center Llc 6699 Fox Centre Pkwy Gloucester VA 23061-6134 Ph: () - | Willow Tree Healing Center Llc 1516 Newmoore Dr Gloucester VA 23061 Ph: (252) 619-0887 |
| NPI Number | 1144807553 |
|---|---|
| Provider Enumeration Date | 03/24/2021 |
| Last Update Date | 11/08/2023 |
| Certification Date | 03/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144807553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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