| Authentic Vibrancy Company Pllc | |
|
325 Pine St Ste B Mount Vernon WA 98273-5929 | |
| (360) 420-5930 | |
| (360) 499-2274 |
| Full Name | Authentic Vibrancy Company Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 325 Pine St Ste B, Mount Vernon, Washington |
| Authorized Official Name and Position | Tracy Wiesneske (OWNER) |
| Authorized Official Contact | 3604205930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Vibrancy Company Pllc 325 Pine St Ste B Mount Vernon WA 98273-5929 Ph: (360) 420-5930 | Authentic Vibrancy Company Pllc 325 Pine St Ste B Mount Vernon WA 98273-5929 Ph: (360) 420-5930 |
| NPI Number | 1245116680 |
|---|---|
| Provider Enumeration Date | 08/12/2025 |
| Last Update Date | 08/12/2025 |
| Certification Date | 08/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245116680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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