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General NPI Number Information
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NPI Number | 1578021341
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Entity Type | Organization
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Legal Business Name | WILDFLOWER COUNSELING
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 123 N LOCUST ST STE 201
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City | GRAND ISLAND
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State | NE
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Zip | 68801-6107
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Country | US
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Telephone | 308-380-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 219 WALDO AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4550
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Country | US
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Telephone | 308-850-6397
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Fax |
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Authorized Official
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Title or Position | LIMHP
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Name | STEPHANIE ANNE SAYLOR-BLE
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Credential | MA
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Telephone | 308-380-0027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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