Healthcare Provider Details

I. General information

NPI: 1013869825
Provider Name (Legal Business Name): WILDFLOWER CREATIVE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15948 FREDERICK RD
WOODBINE MD
21797-8526
US

IV. Provider business mailing address

904 AUTUMN RIDGE CT
MOUNT AIRY MD
21771-5755
US

V. Phone/Fax

Practice location:
  • Phone: 410-936-3981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MEGAN BLEIL
Title or Position: THERAPIST/OWNER
Credential: LGPC, RDT
Phone: 410-946-4294