Provider Demographics
NPI:1801829056
Name:SARCHILD, WILDERNESS (MA)
Entity Type:Individual
Prefix:MS
First Name:WILDERNESS
Middle Name:
Last Name:SARCHILD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 NAN KE RAFE PATH
Mailing Address - Street 2:PO BOX 2034
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-1590
Mailing Address - Country:US
Mailing Address - Phone:508-896-9489
Mailing Address - Fax:508-896-9489
Practice Address - Street 1:196 NAN KE RAFE PATH
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-1590
Practice Address - Country:US
Practice Address - Phone:508-896-9489
Practice Address - Fax:508-896-9489
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3403101YM0800X
MA968106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist