Organization
WANDERLUST THERAPEUTIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELBOURNE RICHARD MORAN JR. LICSW (PROPRIETOR)
(978) 483-0182
Entity
Organization
Contact information
Practice address
400 AMHERST ST STE 200, NASHUA, NH 03063-4223
(603) 889-3553
(603) 589-4981
Mailing address
400 AMHERST ST STE 200, NASHUA, NH 03063-4223
(603) 889-3553
(603) 589-4981
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/27/2020
Last updated
08/30/2024
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