Organization
WILLOW TREE HEALING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WILLOUGHBY PRENTISS LPC (OWNER)
(252) 619-0887
Entity
Organization
Contact information
Practice address
1516 NEWMOORE DR, GLOUCESTER, VA 23061
(252) 619-0887
Mailing address
6699 FOX CENTRE PKWY, GLOUCESTER, VA 23061-6134
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/24/2021
Last updated
11/08/2023
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