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General NPI Number Information
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NPI Number | 1124938824
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Entity Type | Organization
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Legal Business Name | WILDFLOWER MIND CO,. LLC
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 28280 PORTAGE PT STE 102
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City | MILLSBORO
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State | DE
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Zip | 19966-4354
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Country | US
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Telephone | 302-214-5718
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Fax |
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Provider Business Mailing Address
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Address Line | 30921 MANCHESTER LN
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City | LAUREL
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State | DE
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Zip | 19956-3587
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | KAYLA THOMAS
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Credential | PMHNP-BC
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Telephone | 410-490-9879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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