Watershed Wellness Collective LLC

NPI #1033966940 in Madison, Tennessee

Provider Information

NPI Number: 1033966940
Entity Type: Organization
Organization Name: Watershed Wellness Collective LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Apr 30, 2024
Last Updated: Apr 30, 2024

Practice Location

Address: 412 GALLATIN PIKE S
City: Madison
State: Tennessee
ZIP Code: 37115-4009
Phone: (310) 266-5044

Authorized Official

Name: MELISSE PRUSINSKI, LMFT
Title: OWNER/PROVIDER
Phone: (310) 266-5044

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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