Provider Demographics
NPI:1225826621
Name:WILD HARE WELLNESS
Entity type:Organization
Organization Name:WILD HARE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-850-7706
Mailing Address - Street 1:314 1ST ST E STE 200
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-2100
Mailing Address - Country:US
Mailing Address - Phone:406-850-7706
Mailing Address - Fax:406-201-8204
Practice Address - Street 1:314 1ST ST E STE 200
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-2100
Practice Address - Country:US
Practice Address - Phone:406-850-7706
Practice Address - Fax:406-201-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty