Organization
WILD PINE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON FAUCHER SHERMAN LPC (LICENSED PROFESSIONAL COUNSELOR)
(541) 904-0403
Entity
Organization
Contact information
Practice address
131 NW HAWTHORNE AVE STE 211, BEND, OR 97703-2958
(619) 890-8425
Mailing address
131 NW HAWTHORNE AVE STE 211, BEND, OR 97703-2958
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/28/2021
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