# LOW TIDE PLAY THERAPY & FAMILY WELLNESS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508603465
- **Authorized official:** HAYDEN JOSEPH AHLBRANDT LPC, LCMHCA, NCC (OWNER)
- **Authorized official phone:** (970) 631-7848

## Contact information

- **Practice address:** 107 CHESTNUT ST, WILMINGTON, NC 28401-3940
- **Practice address phone:** (910) 537-6257
- **Practice address fax:** (910) 360-8084
- **Mailing address:** 7447 CHIPLEY DR, WILMINGTON, NC 28411-6213
- **Mailing address phone:** (970) 631-7848

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/09/2024
- **Last updated:** 07/09/2024