Provider Demographics
NPI:1881452910
Name:WILDFLOWER PSYCH PLLC
Entity type:Organization
Organization Name:WILDFLOWER PSYCH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:408-883-9477
Mailing Address - Street 1:6538 FLYCATCHER LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-8268
Mailing Address - Country:US
Mailing Address - Phone:408-605-4182
Mailing Address - Fax:
Practice Address - Street 1:3333 CLARK RD STE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8437
Practice Address - Country:US
Practice Address - Phone:408-883-9477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)