Organization
WILD NORTH COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIGHE BLACKADAR LCSW (OWNER)
(207) 803-8735
Entity
Organization
Contact information
Practice address
41 DEPOT ST STE 204, BRIDGTON, ME 04009-2298
(207) 803-8735
Mailing address
41 DEPOT ST STE 204, BRIDGTON, ME 04009-2298
(207) 803-8735
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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