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General NPI Number Information
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NPI Number | 1144655929
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Entity Type | Organization
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Legal Business Name | WISHFUL LIVING COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 50 MOUNT ZION RD 2ND FLOOR
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City | YORK
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State | PA
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Zip | 17402-2635
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Country | US
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Telephone | 717-887-5898
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Fax | 717-840-1419
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Provider Business Mailing Address
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Address Line | 3720 KIMBERLY LN
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City | DOVER
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State | PA
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Zip | 17315-5420
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Country | US
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Telephone | 717-887-5898
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Fax |
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Authorized Official
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Title or Position | OWNER,
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Name | MRS. NICOLE S WILDES
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Credential | LPC
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Telephone | 717-887-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 007057
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License Number State | PA
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