| Wonderland Express Llc | |
|
1009 E 9th St Hopkinsville KY 42240-4201 | |
| (931) 338-3983 | |
| Not Available |
| Full Name | Wonderland Express Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1009 E 9th St, Hopkinsville, Kentucky |
| Authorized Official Name and Position | Tonya Wacker (LPCC) |
| Authorized Official Contact | 9313383983 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wonderland Express Llc 1028 Waterford Cir Clarksville TN 37040-2528 Ph: (931) 338-3983 | Wonderland Express Llc 1009 E 9th St Hopkinsville KY 42240-4201 Ph: (931) 338-3983 |
| NPI Number | 1780219014 |
|---|---|
| Provider Enumeration Date | 03/06/2020 |
| Last Update Date | 03/06/2020 |
| Certification Date | 03/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780219014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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