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Organization
WILLOW TREE LIFE COUNSELING LLC
Active
Organization
WILLOW TREE LIFE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERARDINE MARIA WAGGLE MSW, LCSW (MENTAL HEALTH THERAPIST)
(317) 902-6724
Entity
Organization
Contact information
Practice address
10830 MEADOW LAKE DR, INDIANAPOLIS, IN 46229-3500
(317) 902-6724
Mailing address
5660 CAITO DR STE 122, INDIANAPOLIS, IN 46226-1364
(317) 902-6724
(317) 377-3103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005160A
IN
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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