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General NPI Number Information
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NPI Number | 1528923802
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Entity Type | Organization
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Legal Business Name | WILDERNESS & WONDER COUNSELING PLLC
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1639 N ALPINE RD STE 403
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City | ROCKFORD
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State | IL
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Zip | 61107-1440
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Country | US
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Telephone | 608-492-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 1639 N ALPINE RD STE 403
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City | ROCKFORD
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State | IL
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Zip | 61107-1440
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Country | US
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Telephone | 608-492-1992
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Fax |
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Authorized Official
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Title or Position | LCPC
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Name | ASHLEY BAYLOR
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Credential | LCPC
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Telephone | 608-492-1992
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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 |
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License Number State |
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