Individual
CLEO WINSRYG-WILD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
111 EDGARTOWN RD, VINEYARD HAVEN, MA 02568-5601
(508) 693-7900
Mailing address
16B FOREVER WILD WAY, EDGARTOWN, MA 02539
(774) 563-8289
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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