Organization
WILD FOXGLOVES COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRESAYA L LACY LMHCA (OWNER)
(360) 207-4139
Entity
Organization
Contact information
Practice address
4400 NE 77TH AVE STE 275, VANCOUVER, WA 98662-6857
(360) 207-4139
Mailing address
4400 NE 77TH AVE STE 275, VANCOUVER, WA 98662-6857
(360) 207-4139
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2020
Last updated
06/14/2020
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