Provider Demographics
NPI:1528771813
Name:WILD FLOWER CONSULTING
Entity type:Organization
Organization Name:WILD FLOWER CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIALAUNI
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGGS-HOLKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-726-7497
Mailing Address - Street 1:767 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1509
Mailing Address - Country:US
Mailing Address - Phone:773-726-7497
Mailing Address - Fax:
Practice Address - Street 1:767 BROOKWOOD DR
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1509
Practice Address - Country:US
Practice Address - Phone:773-726-7497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty