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General NPI Number Information
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NPI Number | 1669291464
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Entity Type | Organization
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Legal Business Name | WILDFLOWER ROAD COUNSELING, LLC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 94 PLEASANT ST STE 108
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City | ARLINGTON
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State | MA
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Zip | 02476-6532
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Country | US
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Telephone | 508-596-3357
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 550044
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City | NORTH WALTHAM
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State | MA
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Zip | 02455-0044
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Country | US
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Telephone | 508-596-3357
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MOLLY WEINBERG
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Credential |
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Telephone | 508-596-3357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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