Wildwood, Jack
Wildwood, Jack is an sole proprietor health care provider with primary practice located at 133 Gallery Ln , Morrisville VT 05661-9057. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Wildwood, Jack can be contacted via phone (802) 505-9044.Contact Information
Primary practice address
133 Gallery Ln
Morrisville VT 05661-9057
Phone: (802) 505-9044
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 097.0135245 | Vermont |
Profile Details
| NPI number | 1205317906 |
|---|---|
| LBN Legal business name | Wildwood, Jack |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2018 |
| Last updated | Dec 17th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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