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Organization
WILLOW TREE WELLNESS & COUNSELING, LLC
Active
Organization
WILLOW TREE WELLNESS & COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE IACOVONI LCSW, MSW (FOUNDER & CHIEF CLINICIAN)
(570) 336-9921
Entity
Organization
Contact information
Practice address
214 CENTER ST, BLOOMSBURG, PA 17815-1752
(570) 336-9921
(570) 317-2594
Mailing address
214 CENTER ST, BLOOMSBURG, PA 17815-1752
(570) 336-9921
(570) 317-2594
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW017138
PA
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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