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Organization
WILD & WELL RECOVERY LLC
Active
Organization
WILD & WELL RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM AHQUIN PSYCHOLOGY (EXECUTIVE DIRECTOR)
(435) 669-6669
Entity
Organization
Contact information
Practice address
211 E CAMPO DESIERTO RD, TEMPE, AZ 85288-1161
(435) 669-6669
Mailing address
PO BOX 354, LA VERKIN, UT 84745-0354
(435) 669-6669
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
Primary
—
NULL
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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