Healthcare Provider Details
I. General information
NPI: 1932999257
Provider Name (Legal Business Name): WYLLPEN WELLNESS COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 WYLLPEN DR
WEST CHESTER PA
19380-6642
US
IV. Provider business mailing address
200 WYLLPEN DR
WEST CHESTER PA
19380-6642
US
V. Phone/Fax
- Phone: 484-222-8657
- Fax:
- Phone: 484-222-8657
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
NOTEBAERT
Title or Position: OWNER/MEMBER
Credential: LCSW, CAADC
Phone: 484-222-8657