Organization
LORIEN WILDER LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA LORIEN WILDER LCSW (OWNER)
(804) 426-3728
Entity
Organization
Contact information
Practice address
9844 LORI ROAD SUITE 102, CHESTERFIELD, VA 23832
(804) 426-3728
Mailing address
PO BOX 13013, RICHMOND, VA 23225
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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