Provider Demographics
NPI:1578021341
Name:WILD FLOWER COUNSELING
Entity Type:Organization
Organization Name:WILD FLOWER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLMHP
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:308-380-5007
Mailing Address - Street 1:228 S SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-6079
Mailing Address - Country:US
Mailing Address - Phone:308-380-5007
Mailing Address - Fax:
Practice Address - Street 1:228 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-6079
Practice Address - Country:US
Practice Address - Phone:308-380-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty