Organization
BLUE SKY THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DILLON GARRETT WELLIVER LMHC (OWNER/PRIVATE PRACTICE)
(850) 320-2071
Entity
Organization
Contact information
Practice address
6050 SHADY LN, TALLAHASSEE, FL 32309-8960
(850) 320-2071
Mailing address
6050 SHADY LN, TALLAHASSEE, FL 32309-8960
(850) 320-2071
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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