Organization
WILDSTONE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA G HALE LCSW (OWNER, PSYCHOTHERAPIST)
(262) 424-6624
Entity
Organization
Contact information
Practice address
14135 N CEDARBURG RD, MEQUON, WI 53097-1416
(262) 424-6624
Mailing address
189 GREEN BAY RD, CEDARBURG, WI 53012-2901
(262) 424-6624
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7870-123
WI
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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