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Organization

WILDFLOWER THERAPY COLLECTIVE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OCTAVIA HENRY LMFT (OWNER)
(704) 625-6125
Entity
Organization

Contact information

Practice address
1222 KENILWORTH AVE STE 4, CHARLOTTE, NC 28204-2910
(704) 625-6125
Mailing address
1222 KENILWORTH AVE STE 4, CHARLOTTE, NC 28204-2910

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
12/12/2025
Last updated
12/12/2025
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